Prognostic significance of the novel START arterial stiffness index in patients with coronary artery disease after coronary artery bypass grafting

Aim . To study the long-term prognostic value of the novel START vascular stiffness index in patients with coronary artery disease (CAD) after coronary artery bypass grafting (CABG). Material and methods . The study included 256 patients with CAD who underwent CABG at the Kemerovo Research Institute for Complex Issues of Cardiovascular Diseases. Before surgery, vascular stiffness was assessed using the haSTART cardio-ankle index. The mean follow-up period was 9,7±0,9 years. Two following study groups were formed: Group I — haSTART < the median (Me) index of 8,4 (haSTART <Me (n=118)); group II — haSTART ≥ the median (haSTART ≥Me, n=138). The prognostic value of haSTART was studied in relation to the following composite end point (CEP): death, non-fatal myocardial infarction, or stroke. Results . Patients in the haSTART ≥Me group were significantly older than in the haSTART <Me group (p<0,001). In both groups, men predominated (76,2%). During the follow-up period, all-cause death was significantly more common in the haSTART ≥Me group (34,1%) than in the haSTART <Me group (19,5%), p=0,009. Cardiovascular death was also more common in the haSTART ≥Me group than in the haSTART <Me group (23,2% vs 8,5%, p=0,001). In patients with haSTART ≥Ме, CEP was observed in 45,7% of cases, compared to patients with haSTART <Ме (30,5%), p=0,013. Among patients with fatal outcome, the prevalence of patients with haSTART ≥Ме values was higher than in the group of survivors (67,1% and 48,9%, p=0,009). Among patients with CEP — the detection rate of haSTART ≥Ме was 63,6%, which was significantly higher than in the group of survivors without cardiovascular events (47,8%, p=0,013). Kaplan-Meier curves revealed a better long-term prognosis in the haSTART <Me group to the haSTART ≥Me group (p>0,05). Conclusion . Evaluation of the haSTART stiffness index before CABG surgery may have prognostic value in the long-term follow-up period in patients with CAD.