Association between brachial-ankle pulse wave velocity and progression of coronary artery calcium: a prospective cohort study

Background: Few studies have investigated the association between coronary artery calcium (CAC) progression and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV). We examined the influence of the severity of baseline baPWV on CAC progression in a large prospective cohort. Methods: A total of 1600 subjects who voluntarily participated in a comprehensive health-screening program between March 2010 and December 2013 and had baseline baPWV as well as CAC on baseline and serial follow-up computed tomography performed approximately 2.7 +/- 0.5 years apart were enrolled in the study. Results: A total of 1124 subjects were included in the analysis (1067 men; mean age, 43.6 +/- 5.1 years). An increased CAC score was found in 318 subjects (28.3 %) during the follow-up period. Baseline higher baPWV was significantly correlated with CAC progression, especially in subjects with third-and fourth-quartile values (adjusted odds ratio [OR] 2.04; 95 % confidence interval [CI] 1.33-3.15 and OR 2.14; 95 % CI 1.34-3.41, respectively) compared with the lowest-quartile values (P for trend <0.001). A similar effect was observed in diabetic subjects. Among the 835 subjects with a baseline CAC score = 0, progression to CAC score >0 was associated with male sex, diabetes, and higher baPWV. However, among the 289 individuals with a baseline CAC score >0, only the presence of CAC itself was predictive of CAC progression. Conclusions: Higher arterial stiffness measured by baPWV could be significantly associated with CAC progression.