ИСТИНА

The AIM of the study was establish whether changes of brachial-ankle pulse wave velocity (baPWV) after treatment are predictors of major adverse cardiovascular events (MACE) in women already diagnosed with Coronary Artery Disease (CAD). METHODS AND RESULTS: baPWV measurement was performed on 88 women with CAD (mean age 65,9±7,7) using conventional therapy (IACE-61%, β-blocker-69%, statins-34%, сalcium channel blockers-54%, nitrates -33%) at baseline and after six months. During the 4-year follow-up period 14 patients experienced MACE (acute myocardial infarction, coronary intervention, or cardiac death) (2 before 6 month-point and 12 after). RESULTS: There are no difference in baPWV at base line between groups with MACE and without MACE. After six months follow-up, baPWV had not improved (ΔbaPWV ≥0% relative to baseline) in 28.4% women (group 1), whereas it had significantly improved (ΔbaPWV <0% relative to baseline) in the remaining 71.6% (group 2). During follow-up 8 events in group 1 and 4 events in group 2 (p < 0.001) occurred. 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 38,1% and the positive predictive value was 92,5%. The sensitivity of baPWV was 67%, and its specificity was 79%. After 6 months SBP and DBP decreased by 8,8% and 6,6%. Changes in BP were not significant associated with a 3,5 years prognosis. CONCLUSIONS: An improvement in arterial stiffness may be obtained after six months of conventional therapy and clearly indicates a more favorable prognosis. Decrease of BP does not relate to meaningful 3,5 years prognosis improvement in women with CAD.