# Association of estimated pulse wave velocity with outcomes following drug-coated balloon therapy in elderly coronary artery disease patients

## TL;DR

This study finds that higher pulse wave velocity in elderly patients is linked to increased risk of heart-related complications after drug-coated balloon therapy.

## Contribution

The study identifies a novel cutoff value for pulse wave velocity to stratify clinical risk in elderly coronary patients post-DCB therapy.

## Key findings

- Elevated estimated pulse wave velocity (ePWV) is associated with higher risks of target lesion revascularization and major adverse cardiovascular events.
- A cutoff ePWV of 10.91 m/s effectively differentiates high- and low-risk patient groups.
- The predictive value of ePWV is more pronounced in female patients.

## Abstract

Drug-coated balloons (DCBs) constitute a vital therapeutic approach in the interventional management of coronary heart disease. Nevertheless, the risk factors for predicting target lesion revascularization (TLR) and major adverse cardiovascular events (MACE) specifically within the elderly population following DCB angioplasty remain incompletely understood. The study is to explore the relationship between estimated pulse wave velocity (ePWV) values and the risk of TLR and MACE in elderly patients undergoing DCB treatment, and to explore the optimal ePWV cutoff for clinical risk stratification.

A total of 423 participants were stratified into quartiles based on their ePWV values. Baseline characteristics were compared among these quartiles. The associations between ePWV and the risk of TLR and MACE were evaluated using Cox regression models, adjusted for multiple covariates. Kaplan–Meier analysis with the log-rank test was utilized to assess survival differences. The optimal ePWV cutoff for risk stratification was identified through maximally selected rank statistics. Subgroup analyses were performed to examine interactions between ePWV and clinical variables.

Differences emerged across ePWV quartiles for age, TLR, and MACE (all P < 0.05). Multivariate Cox regression revealed that elevated ePWV was associated with a higher risk of TLR (per unit increase: adjusted HR 1.46, 95% CI 1.18–1.79, P < 0.001) and MACE. A dose-response relationship was observed, with the highest ePWV quartile exhibiting the highest risk compared to the lowest. Kaplan–Meier curves showed differences in survival across quartiles (TLR: log-rank P = 0.012; MACE: P < 0.05). The optimal ePWV cutoff was identified at 10.91 m/s, differentiating high- and low-risk groups (log-rank P < 0.05). Notably, subgroup analysis revealed sex-based interactions for both TLR and MACE, with the predictive value being consistently more pronounced in females.

Elevated ePWV was associated with a higher risk of TLR and MACE. An exploratory cutoff for ePWV at 10.91 m/s was identified, stratifying patients into distinct clinical risk groups.