research abstract

For anyone interested, herewith the abstract accepted by Heart, Lung and Circulation related to the Cardanal research.

Alternative Risk Markers in Coronary Artery Disease (ARMCAD Study): Interim Analysis
Heart, Lung and Circulation, Volume 16, Supplement 2, 2007, Pages S127-S128
D. Kotecha, H. Krum, B. Billah, M. Flather, L. Roberts and D. Eccleston

Abstract 318

Background: Traditional 'Framingham' risk factors are widely used in prediction of coronary heart disease (CHD) and

cardiovascular events both in patients with and without existing diseases. Recent studies have confirmed poor

prediction and lack of outcome change using such methods. The purpose of this study is to create a new model to

stratify CHD risk using a broad selection of non-invasive and rapidly assessable variables.
Methods: Seventy consecutive participants were recruited prior to elective coronary angiography for suspected CHD.

Traditional risk factors, pulse wave analysis aof teh radial artery (PWA), 5-min heart rate variability (HRV),

waist-hip ratio and body mass indiex (BMI) were measured in this analysis.
Results:Good quality pulse waveforms were achievable within 2 weeks in 5 operators (mean quality index 89.7% +/- 6.7%). Apart from a weak correlation between BMI and augmentation index of PWA, the four categories of risk variables were independent. Patients with triple vessel disease (3VD) had significantly lower total power of HRV (mean 657ms2 versus 1485ms2 with <3VD, p<0.01). Standard deviation of HRVand low frequency power were also significantly lower in logistic regression (p=0.045), 0.025). Odds ratios for 3VD were 6.5 for pNN50 (p=0.01) and 8.6 8.6 for total power (p=0.03) at defined cutoffs. PWA and traditional risk varaiables did not reach statistical significance.
Conclusion: Low 5-min HRV identifies patients with severe CHD. A multivariate model encompassing these variables plus cardiac biomarkers may improve prediction of teh presence and severity of coronary disease.