Potential Of The Novel START Index In Assessing Arterial Stiffness In Patients With Coronary Artery Disease

Background — Recently, a novel method for assessing arterial stiffness was developed under the name of START (STiffness of ARTeries), which, unlike the conventional stiffness parameter β, is calculated based on other physical principles. Our study aimed to investigate the possibility of using the new START index in patients with coronary artery disease (CAD). Methods — The study included 353 patients with CAD: 277 men and 76 women. Their median age was 57.0 (53.0; 64.0) years. The arterial stiffness was assessed in all subjects using VaSera VS-1000 sphygmomanometer. The novel arterial stiffness index (START) was analyzed retrospectively. We assessed the correlation of cardio-ankle vascular index (CAVI) and START index, as well as each of these indices with risk factors in the entire cohort of those examined, and also separately for men and women. Results — In examined CAD patients, the median value of the CAVI was within the borderline values (8.0-9.0) [5]: 8.3 (7.6; 9.2) on the right side and 8.3 (7.6; 9.2) on the left side. A median value of the START index was 8.3 (7.1; 9.8) on the right and 8.1 (7.0; 9.6) on the left. A strong relationship between CAVI and START was revealed in the total sample (r=0.879, p<0.001). Women exhibited a more pronounced association (r=0.982, p<0.001) than men (r=0.805, p<0.001). For the total sample, we revealed a strong dependence of the indices on age (r=0.4, p<0.001 for CAVI; r=0.36, p<0.001 for the START index). Both stiffness indices exhibited a weak but significant correlation with glomerular filtration rate (GFR) in the entire sample of study subjects (r=-0.168, p=0.003 for CAVI; r=-0.0159, p=0.004 for START). Conclusion — In patients with CAD, the START index was strongly associated with the CAVI throughout the entire cohort, albeit the correlation in women was slightly stronger than in men. Also, these indices had similar associations with clinical factors and age. Strong correlation between these indices is important for the subsequent practical application of the START index. The possibility of using START index in similar clinical situations as the CAVI requires confirmation in further studies.