The usefulness of brachial-ankle pulse wave velocity in predicting long-term cardiovascular events in younger patients

Abstract

Brachial-ankle pulse wave velocity (baPWV) is known as a significant predictor of cardiovascular events. However, the previous studies have not considered age, which can affect the baPWV value. We evaluated the predictive value of baPWV for cardiovascular events in various age groups. From January 2005 to December 2012, all patients admitted to our department with any cardiovascular disease and underwent ankle-brachial index (ABI) measurement were enrolled in the IMPACT-ABI registry. The primary endpoints included major adverse cardiovascular events (MACE; cardiovascular death, myocardial infarction, and stroke). Of the 3131 patients enrolled, 2554 were included in the analysis, whereas 577 were excluded due to missing baPWV data, ABI ≤0.9 and/or >1.4, and the previous endovascular therapy and/or surgical treatment for peripheral artery disease. Patients were divided according to age 30-59 years (n = 580), 60-69 years (n = 730), 70-79 years (n = 862), and ≥80 years (n = 330). The cumulative incidence of MACE through 5 year was significantly higher in the high baPWV group (>1644 cm/s) than in the low baPWV group (≤1644 cm/s; 8.7 vs. 4.6%; log-rank: p < 0.001). However, among the age groups, only the 30-59-year group showed a significant difference in MACE incidence between those with high and low baPWV (7.0 vs. 0.9%; log-rank: p = 0.001). In conclusion, the baPWV could serve as a useful marker to predict cardiovascular events, particularly among younger patients.

Peripheral arterial stiffness as a surrogate of central hemodynamics: A new era for cardiovascular risk estimation?

“…With respect to different age groups, a significant association between high baPWV and CV events was noted in younger patients (30-59 years); on the contrary, such relations were not observed in older age groups, suggesting a potential predictive significance of baPWV in younger patients. 10 Similar associations have been found in studies of patients with overt CV disease. In patients with non-ST-elevation myocardial infarction, major CV events and CV mortality were higher in patients with high baPWV (17 m/s) compared with patients with lower values.…”

“…Among all participants, the risk for major CV events was significantly increased in the high, compared with the low, baPWV group. With respect to different age groups, a significant association between high baPWV and CV events was noted in younger patients (30‐59 years); on the contrary, such relations were not observed in older age groups, suggesting a potential predictive significance of baPWV in younger patients …”

Geriatric Nutritional Risk Index Predicts Cardiovascular Events in Patients at Risk for Heart Failure

“…Details of the IMPACT-ABI study have been published. [14][15][16][17] In summary, we retrospectively identified 4,619 consecutive patients who were admitted to the Department of Cardiology at Shinshu University Hospital for any CV disease between January 2005 and December 2012. Of these, 1,488 patients were excluded because of missing ABI data, and the remaining 3,131 patients were enrolled in the IMPACT-ABI study.…”

Static intra-access pressure ratio and cardiovascular events in patients undergoing haemodialysis

“…In fact, previous studies have shown that central arterial stiffness is a strong predictor of cardiovascular mortality in patients with ESRD 17,19 . Of note, there is also enough literature evidence demonstrating that the baPWV is an independent predictor of cardiovascular events and mortality [20][21][22][23][24][25] . However, theoretically, the baPWV, which reflects peripheral arterial stiffness, is limited in predicting cardiovascular events.…”