Arterial stiffness as a risk factor for cardiovascular events and all‐cause mortality in people with Type 2 diabetes

Abstract

Aim To quantify the risk of different non‐invasive arterial stiffness measurements with macrovascular disease and all‐cause mortality in high‐risk people with Type 2 diabetes. Methods We conducted a prospective cohort study of 1910 people with Type 2 diabetes included in the Second Manifestations of ARTerial disease (SMART) study. Arterial stiffness was assessed by brachial artery pulse pressure, normal range (≥0.9) ankle–brachial index and carotid artery distension. Cox regression was used to evaluate the effects of arterial stiffness on risk of cardiovascular events (composite of myocardial infarction, stroke and vascular mortality) and all‐cause mortality. Results A total of 380 new cardiovascular events and 436 deaths occurred during a median (interquartile range) follow‐up of 7.5 (4.1–11.0) years. A 10‐mmHg higher brachial pulse pressure was related to higher hazard of cardiovascular events (hazard ratio 1.09, 95% CI 1.02 to 1.16) and all‐cause mortality (hazard ratio 1.10, 95% CI 1.03 to 1.16). A 0.1‐point lower ankle–brachial index within the normal range was related to a higher hazard of cardiovascular events (hazard ratio 1.13, 95% CI 1.01 to 1.27) and all‐cause mortality (hazard ratio 1.17, 95% CI 1.04 to 1.31). A one‐unit (10−3×kPa−1) lower carotid artery distensibility coefficient was related to a higher hazard of vascular mortality (hazard ratio 1.04, 95% CI 1.00 to 1.09) and all‐cause mortality (hazard ratio 1.04, 95% CI 1.00 to 1.07). Conclusion Increased arterial stiffness, as measured by either increased pulse pressure, normal‐range ankle–brachial index or carotid artery distensibility coefficient, is related to increased hazard of cardiovascular events and all‐cause mortality in people with Type 2 diabetes.

Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study

“…A meta-analysis of longitudinal cohort studies reported a significant association between baPWV and CV mortality [ 22 ]. A few studies have reported that increased arterial stiffness, measured by baPWV or brachial pulse pressure, could predict mortality and CV events in subjects with diabetes [ 17 , 23 ]. Several other prospective studies demonstrated that the optimal cutoff of baPWV for predicting CV mortality in a general population of elderly subjects was 1963 cm/s [ 24 ] and that for predicting a future CV event was 1800 cm/s [ 25 ].…”

Long Non-Coding RNAs (lncRNAs) in Cardiovascular Disease Complication of Type 2 Diabetes

“…In the T2D environment, one of the early critical events for CVD complications is the increase in arterial stiffness and endothelial cell damage that contributes to atherosclerosis [ 95 , 96 ]. The high levels of circulating glucose and lipids are significant determinants for both arterial stiffness and carotid intimal media thickness (IMT) [ 97 , 98 ], and this association is only evident in T2D patients [ 99 ].…”

The computational Patient has diabetes and a COVID

“…There are complex multifactorial links between diabetes and cardiovascular disease [59,60,61,62]. The main pathophysiology cornerstone is a state of chronic, low-level inflammation.…”