Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schnaubelt, S; Oppenauer, J; Bader, M; DU, N; Eibensteiner, F; Kienbacher, CL; Baldi, E; Mueller, M; Perkmann, T; Haslacher, H; Schreiber, W; Niessner, A; Schlager, O; Domanovits, H; Sulzgruber, P.
Arterial stiffness in acute coronary syndrome as a potential triage tool: a prospective observational study.
Minerva Med. 2023; 114(1): 1-14.
Doi: 10.23736/S0026-4806.22.07909-5
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Bader Mathias
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- Abstract:
- BACKGROUND: Diagnosis and percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) are time-sensitive. Triage and algorithms identify patients at high-risk. However, additional prediction tools are warranted for prioritized care based on predicted coronary pathologies and PCI complexity. Pulse-wave velocity (PWV) is a non-invasive measurement related to cardiovascular morbidity, and their exact value in ACS evaluation is unclear. METHODS: In patients undergoing coronary angiography (CA) and - if warranted - PCI for ACS evaluation at a tertiary university hospital in Vienna, Austria, brachial-ankle (ba)PWV and carotid-femoral (cf)PWV were prospectively measured from January 2020 to January 2021. RESULTS: PWV was measured in 58 patients (60.3% male; 65 [61-69] years). Risk prediction scores (GRACE, CRUSADE, TIMI), cardiac enzymes, and fraction of patients with a three-vessel disease were significantly higher in the pathological PWV ranges. Adjusted for age and comorbidities, baPWV independently predicted the LAD being relevantly stenotic (crude OR=1.416 [1.143-1.755], P=0.001; adjusted OR=1.340 [1.039-1.727], P=0.024; cut-off 15.5 m/s in CART-analysis), being the culprit lesion (crude OR=1.320 [1.094-1.594], P=0.004; adjusted OR=1.311 [1.037-1.657], P=0.024; cut-off 15.5 m/s), and being totally occluded (crude OR=1.422 [1.113-1.818], P=0.005; adjusted OR=1.677 [1.189-2.366], P=0.003; cut-off 19.6 m/s). Moreover, CA or PCI complexity were associated with higher PWV. CONCLUSIONS: Pathological PWV as a surrogate for arterial stiffness, polyvascular disease and a larger atherosclerotic burden was associated with GRACE, CRUSADE, and TIMI scores, and PCI duration and complexity. BaPWV independently predicted relevant LAD pathologies, and is suggested as a potential novel triage and prioritization tool for suspected NSTE-ACS in emergency departments.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Male - administration & dosage
- Female - administration & dosage
- Acute Coronary Syndrome - diagnosis
- Vascular Stiffness - administration & dosage
- Percutaneous Coronary Intervention - administration & dosage
- Triage - administration & dosage
- Heart - administration & dosage
- Find related publications in this database (Keywords)
- Acute coronary syndrome
- Percutaneous coronary intervention
- Coronary angiography
- Pulse wave analy-sis
- Vascular stiffness