Aortic pulse wave velocity (PWV) is a predictor of atherosclerosis. The percent mean pulse amplitude of the artery (%MPA) has been proposed as a novel marker of atherosclerosis. The present study evaluated the predictive value of PWV and the %MPA for coronary atherosclerosis. The severity of coronary atherosclerosis was evaluated using both the Gensini score and coronary calcium grade. Thirty-three patients with cardiovascular risk factors were assigned to those with significant coronary artery stenosis ((+)stenosis) group with the presence of > or = 75% coronary artery stenosis (n = 15; age: 68 +/- 7 years, mean +/- SD) or those without significant coronary artery stenosis ((-)stenosis) group (n = 18; age: 66 +/- 8 years). In each patient, the PWV and %MPA at the right brachial artery and both sides of the ankle were obtained using a non-invasive vascular screening device. The Gensini score and coronary calcium grade were higher in the +stenosis group than they were in the (-)stenosis group (P < 0.01 and P < 0.05, respectively). The brachial %MPA was lower in the (+)stenosis group than it was in the -stenosis group (P < 0.005). Both the Gensini score and the coronary calcium grade correlated with the brachial %MPA (r = 0.62, P = 0.0001 and P = 0.33, P = 0.030, respectively). Our observations suggest that brachial %MPA provides predictive values for coronary atherosclerosis in subjects at risk for cardiovascular disease.