Usefulness of Estimated Pulse Wave Velocity in Prediction of Cardiovascular Mortality in Patients With Acute Myocardial Infarction

Hsu, Po-Chao; Lee, Wen-Hsien; Tsai, Wei–Chung; Chi, Nai-Yu; Chang, Ching-Tang; Chiu, Chih-Yi; Chu, Chun-Yuan; Lin, Tsung‐Hsien; Lai, Wen‐Ter; Sheu, Sheng‐Hsiung; Su, Ho‐Ming

doi:10.1016/j.amjms.2020.10.023

Cited by 15 publications

(14 citation statements)

References 28 publications

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“… 24 , 25 In high‐risk patients from the SPRINT trial, ePWV was associated with a composite cardiovascular end point and all‐cause mortality during 3.26 years follow‐up and improved C‐statistics beyond the Framingham Risk Score (from 0.67; 95% CI, 0.64–0.69; to 0.69; 95% CI, 0.66–0.72). 13 Similarly, ePWV was associated with cardiovascular and all‐cause mortality in 2 smaller high‐risk Asian cohorts 27 , 28 and in a high‐risk European cohort by Hametner et al ePWV was associated with a combined end point (mortality, stroke, MI, and unplanned revascularization). 29 …”

Section: Discussionmentioning

confidence: 91%

Estimated Pulse Wave Velocity Is Associated With All‐Cause Mortality During 8.5 Years Follow‐up in Patients Undergoing Elective Coronary Angiography

Laugesen

Olesen

Peters

et al. 2022

JAHA

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Background Estimated pulse wave velocity (ePWV) calculated by equations using age and blood pressure has been suggested as a new marker of mortality and cardiovascular risk. However, the prognostic potential of ePWV during long‐term follow‐up in patients with symptoms of stable angina remains unknown. Methods and Results In this study, ePWV was calculated in 25 066 patients without diabetes, previous myocardial infarction (MI), stroke, heart failure, or valvular disease (mean age 63.7±10.5 years, 58% male) with stable angina pectoris undergoing elective coronary angiography during 2003 to 2016. Multivariable Cox models were used to assess the association with incident all‐cause mortality, MI, and stroke. Discrimination was assessed using Harrell´s C‐index. During a median follow‐up period of 8.5 years (interquartile range 5.5–11.3 years), 779 strokes, 1233 MIs, and 4112 deaths were recorded. ePWV was associated with all‐cause mortality (hazard ratio [HR] per 1 m/s, 1.13; 95% CI, 1.05–1.21) and MI (HR per 1 m/s 1.23, 95% CI, 1.09–1.39) after adjusting for age, systolic blood pressure, body mass index, smoking, estimated glomerular filtration rate, Charlson Comorbidity Index score, antihypertensive treatment, statins, aspirin, and number of diseased coronary arteries. Compared with traditional risk factors, the adjusted model with ePWV was associated with a minor but likely not clinically relevant increase in discrimination for mortality, 76.63% with ePWV versus 76.56% without ePWV, P <0.05. Conclusions In patients with stable angina pectoris, ePWV was associated with all‐cause mortality and MI beyond traditional risk factors. However, the added prediction of mortality was not improved to a clinically relevant extent.

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Section: Discussionmentioning

confidence: 91%

Estimated Pulse Wave Velocity Is Associated With All‐Cause Mortality During 8.5 Years Follow‐up in Patients Undergoing Elective Coronary Angiography

Laugesen

Olesen

Peters

et al. 2022

JAHA

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“…Despite the weak associations between ePWV and cfPWV noted herein, ePWV may still hold promise as a measure of vascular aging and CVD risk. ePWV has been shown to predict cardiovascular and cerebrovascular events and all-cause mortality independent of traditional CVD risk factors (including the following adjustment for age and BP) [8][9][10][11][12][13][14]29,[43][44][45] . Recently, ePWV was shown to improve risk stratification for all-cause mortality in hospitalized patients with COVID-19 beyond traditional risk factors and risk scores [30] .…”

Section: Implications and Additional Considerationsmentioning

confidence: 99%

Associations between estimated and measured carotid-femoral pulse wave velocity in older Black and White adults: the atherosclerosis risk in communities (ARIC) study

Heffernan¹,

Stoner²,

Meyer³

et al. 2022

JCA

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Introduction: Aortic stiffness offers important insight into vascular aging and cardiovascular disease (CVD) risk. The referent measure of aortic stiffness is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated (ePWV) from age and mean arterial pressure. Few studies have directly compared the association of ePWV to measured cfPWV, particularly in non-White adults. Moreover, whether ePWV and cfPWV correlate similarly with CVD risk remains unexplored. Aim: (1) To estimate the strength of the agreement between ePWV and cfPWV in both Black and White older adults; and (2) to compare the associations of ePWV and cfPWV with CVD risk factors and determine whether these associations were consistent across races. Methods and Results: We evaluated 4478 [75.2 (SD 5.0) years] Black and White older adults in the Atherosclerosis Risk in Communities (ARIC) Study. cfPWV was measured using an automated pulse waveform analyzer. ePWV was derived from an equation based on age and mean arterial pressure. Association and agreement between the two measurements were determined using Pearson’s correlation coefficient (r), standard error of estimate (SEE), and Bland-Altman analysis. Associations between traditional risk factors with ePWV and cfPWV were evaluated using linear mixed regression models. We observed weak correlations between ePWV and cfPWV within White adults (r = 0.36) and Black adults (r = 0.31). The mean bias for Bland-Altman analysis was low at -0.17 m/s (95%CI: -0.25 to -0.09). However, the inspection of the Bland-Altman plots indicated systematic bias (P < 0.001), which was consistent across race strata. The SEE, or typical absolute error, was 2.8 m/s suggesting high variability across measures. In models adjusted for sex, prevalent diabetes, the number of prevalent cardiovascular diseases, and medication count, both cfPWV and ePWV were positively associated with heart rate, triglycerides, and fasting glucose, and negatively associated with body mass index (BMI) and smoking status in White adults (P < 0.05). cfPWV and ePWV were not associated with heart rate, triglycerides, and fasting glucose in Black adults, while both measures were negatively associated with BMI in Black adults. Conclusions: Findings suggest a weak association between ePWV and cfPWV in older White and Black adults from ARIC. There were similar weak associations between CVD risk factors with ePWV and cfPWV in White adults with subtle differences in associations in Black adults. One sentence summary: Estimated pulse wave velocity is weakly associated with measured carotid-femoral pulse wave velocity in older Black and White adults in ARIC.

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“…Many studies have considered ePWV > 10 m/s an important risk factor for the development of related diseases [20][21][22]. However, Further analysis is required because this division based solely on median value cannot capture the overall trend in predicting disease risk.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with cf-PWV, ePWV is a convenient and affordable indicator that combines age and BP to evaluate arterial stiffness. In recent years, ePWV has widely been used as an indicator to predict disease risk in various populations, including the general population, patients with stroke, and those with CVD [20,21,42]. Moreover, ePWV revealed a better performance than the Framingham risk score (FRS) in predicting CVD (P = 0.044) and overall mortality (P < 0.001); however, no signi cant difference was observed between baPWV and FRS (P > 0.05 for both) [22].…”

Section: Discussionmentioning

confidence: 99%

Predictive value of estimated pulse wave velocity for cardiovascular and all- cause mortality in individuals with obesity

Cao

Cheng

et al. 2023

Preprint

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Background: Estimated pulse wave velocity (ePWV) has revealed excellent performance in predicting cardiovascular disease (CVD) risk. However, whether ePWV predicts all-cause mortality and CVD mortality in populations with obesity remains elusive. Methods: We performed a prospective cohort including 49,116 participants from the National Health and Nutrition Examination Survey from 2005 to 2014. Arterial stiffness was evaluated by ePWV. Weighted univariate and multivariate Cox regression was used to assess the effects of ePWV on the risk of all-cause and CVD mortality. In addition, the two-piecewise linear regression analysis was used to describe the trend of ePWV affecting mortality and identify the thresholds that significantly affect mortality. Results: A total of 9,929 participants with obesity with ePWV data and 833 deaths were enrolled. Based on the multivariate Cox regression results, the high ePWV group had a 1.25-fold higher risk of all-cause mortality and a 5.76-fold higher risk of CVD mortality than the low-ePWV group. All-cause and CVD mortality risk increased by 123% and 44%, respectively, for every 1 m/s increase in ePWV. Furthermore, the two-piecewise linear regression analysis exhibited that the minimal threshold at which ePWV affected participant mortality was 6.7 m/s for all-cause mortality and 7.2 m/s for CVD mortality. Conclusions: ePWV was an independent risk factor for mortality in populations with obesity. High ePWV levels were associated with an increased all-cause and CVD mortality. Thus, ePWV can be considered a novel biomarker to assess mortality risk in patients with obesity.

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Usefulness of Estimated Pulse Wave Velocity in Prediction of Cardiovascular Mortality in Patients With Acute Myocardial Infarction

Cited by 15 publications

References 28 publications

Estimated Pulse Wave Velocity Is Associated With All‐Cause Mortality During 8.5 Years Follow‐up in Patients Undergoing Elective Coronary Angiography

Estimated Pulse Wave Velocity Is Associated With All‐Cause Mortality During 8.5 Years Follow‐up in Patients Undergoing Elective Coronary Angiography

Associations between estimated and measured carotid-femoral pulse wave velocity in older Black and White adults: the atherosclerosis risk in communities (ARIC) study

Predictive value of estimated pulse wave velocity for cardiovascular and all- cause mortality in individuals with obesity

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