ИСТИНА

BACKGROUND: Men with CAD have been shown to have abnormal arterial stiffness. Arterial function may change over time, according to treatment; the prognostic value of these changes has not been investigated. OBJECTIVES: The aim of the present study was to assess whether an improvement of lager artery rigidity in response to treatment, could predict a more favorable prognosis in a population of men with CAD. METHODS: A total of 157 consecutive men with CAD (mean age 56,9±10,8), using conventional therapy (IACE-63%, β-blocker-88%, statins-96%, сalcium channel blockers-25%, nitrates -21%) underwent brachial-ankle pulse wave velocity (baPWV) measurement at baseline and after six months. During the 3,5-year follow-up period 38 patients experienced MACE (acute myocardial infarction, coronary intervention, or cardiac death).RESULTS: After six months follow-up, baPWV had not improved (ΔbaPWV ≥0% relative to baseline) in 85 (54.1%) of 157 men (group 1), whereas it had significantly improved (ΔbaPWV <0%) in the remaining 76 men (45.9%) (group 2). During follow-up, we noticed 24 events (8,08 per 100 person-years) in group 1 and 6 events (2,25 per 100 person-years) in group 2 (p < 0.001). Cox analyses demonstrated that independent of age at base line and BP changes, absence of baPWV decrease was predictor of MACE. The negative predictive value of baPWV was 28,2% and the positive predictive value was 92,1%. The sensitivity of baPWV was 80%, and its specificity was 54%. CONCLUSIONS: This study demonstrates that an improvement in arterial stiffness may be obtained after six months of ordinary therapy and clearly identifies patients who have a more favorable prognosis.