Deterioration of indices of aortic augmentation and vascular age predate major cardiac events and interact with opiate dependence

Pulse wave analysis (PWA) by radial arterial tonometry is receiving increasing attention for the assessment of central vascular compliance in younger patients. We present five PWA studies performed prospectively on a patient with severe coronary artery disease, and find that the measures of central augmented pressure and particularly the difference between the vascular age and the chronological age, the central augmentation time index, and the central augmentation pressure, were the most sensitive indices of deteriorating vascular function. Secondly, as the patient was also an opiate addict, it raises the question about the documented but not widely known, interaction between opiate drug use and his coronary disease.