Purpose: Arterial stiffness (AS) is associated with, and a predictor of, outcome in patients with renal and cardiovascular disease. In this study we measured different indices of arterial stiffness, and determinants of these, in subjects with various degrees of coronary artery disease (CAD). We also assessed their predictive value, and that of renal function, for cardiovascular morbidity and mortality.

Methods: Subjects were included following evaluation of CAD at coronary angiography. AS was measured using pulse wave velocity (PWV), pulse wave analysis (PWA) and digital volume pulse (DVP) analysis. Renal function was assessed using serum creatinine concentration [creat]_sr and estimated glomerular filtration rate (eGFR) using the Cockcroft & Gault equation. Subjects with a history of renal disease were excluded. The primary-endpoint was a composite of hospitalisation due to cardiovascular causes and all-cause mortality.

Results: 284 subjects (210 males), with a mean age of 62 years, were included. Compared with PWV, the augmentation, reflection and stiffness indices did not confer similar information. PWV was determined by age, heart rate, systolic BP, body mass index and [creat]_sr (R² = 0.38, p < 0.001), and negatively associated with eGFR (R² = 0.30, p < 0.001). Follow-up was for a mean of 1.5 years. A lower eGFR (p < 0.01), PWVs above the median (p < 0.05) and degree of CAD (p < 0.001) predicted a shorter time to a composite endpoint.

Conclusion: In our study renal function rather than traditional cardiovascular risk factors determined AS. EGFR, PWV and degree of CAD were predictive of cardiovascular outcome.