BACKGROUND AND AIMS Increased arterial stiffness is associated with a higher risk of future cardiovascular events. We aimed to investigate whether information about arterial stiffness provides additional prognostic value to coronary computed tomography angiography (CCTA) findings.

METHODS A total of 523 consecutive patients (mean age, 58.0 ± 10.3 years; male, 60.6%) with suspected coronary artery disease (CAD), who underwent CCTA and brachial-ankle pulse wave velocity (baPWV) measurement within a month, were retrospectively analyzed. A composite of cardiovascular death, nonfatal myocardial infarction (MI), coronary revascularization, nonfatal stroke, and hospitalization for cardiovascular causes was assessed.

RESULTS During a median 43.9 months of follow-up (interquartile range, 11.6-66.9 months), the composite endpoint occurred in 66 patients (3 cardiovascular deaths, 1 nonfatal MI, 35 coronary revascularizations, 16 nonfatal strokes, and 45 hospitalizations for cardiovascular causes). After adjustment for clinical risk factors and CCTA findings, higher baPWV was an independent prognostic factor for the composite endpoint (adjusted hazard ratio, 4.717; 95% confidence interval, 2.675-8.319; p < 0.001). The addition of baPWV to clinical risk factors and CCTA findings significantly improved the prediction of cardiovascular events (global χ² score, from 132 to 154; p = 0.005).

CONCLUSIONS Arterial stiffness provides additional prognostic information to CCTA findings in patients with suspected CAD. The baPWV can serve as a useful clinical tool for risk stratification in this population.