A 1 SD increment in central arterial systolic pressure-time index was associated with an increased risk of cardiovascular endpoints (HR 1.37; 95% CI 1.18-1.59).
Cohort (n=5,099)
Yes
Do central arterial systolic (SPTI) and diastolic (DPTI) pressure-time indexes and subendocardial viability ratio (SEVR) improve risk stratification for cardiovascular endpoints in the general population?
Central arterial systolic and diastolic pressure-time indexes (SPTI and DPTI) significantly improve cardiovascular risk stratification in the general population, whereas the subendocardial viability ratio (SEVR) does not.
Hazard Ratio: 1.37 (95% CI 1.18–1.59)
Objective: Growing researches focused on the central arterial systolic (SPTI) and diastolic (DPTI) pressure-time indexes and the subendocardial viability ratio (SEVR). However, whether these indexes contribute to risk stratification in the general population is unknown. Design and method: SPTI, DPTI and SEVR were noninvasively measured by the SphygmoCor technology. Incidence rates and standardized (per 1 SD increment) multivariable-adjusted hazard ratios (HRs) for cardiovascular (primary) and cardiac endpoints and stroke were evaluated in the International Database of Central Arterial Properties for Risk Stratification (n=5099). Model refinement was assessed by the area under the curve (AUC) and the integrated discrimination (IDI) and net reclassification (NRI) improvement. Results: Over 4 years (median), 215 cardiovascular, 133 cardiac endpoints and 79 strokes occurred. For SPTI, fully adjusted HRs were 1.37 (95% CI: 1.18-1.59), 1.35 (1.11-1.64) and 1.33 (1.05-1.69) for the cardiovascular and cardiac endpoints and stroke. The corresponding HRs for DPTI were 1.49 (1.31-1.69), 1.23 (1.02-1.48) and 1.74 (1.46-2.07). For SEVR, none of the HRs reached significance. Analyses with these indexes categorized by quartiles were confirmatory. Analyses stratified by various risk factors did not reveal subgroup differences. For the cardiovascular endpoint, adding SPTI or DPTI to the base model improved the AUC, while adding SPTI or DPTI combined with mean arterial pressure, increased IDI by ∼1.7% and NRI by ∼17% (P<0.001 for all). Conclusions: SPTI and DPTI improve risk stratification in people representative of the general population. The use of SEVR might be limited to diseased patients, in particular those with coronary heart disease or heart failure.
Huang et al. (Fri,) conducted a cohort in General population (n=5,099). Central arterial systolic (SPTI) and diastolic (DPTI) pressure-time indexes vs. Lower levels (evaluated per 1 SD increment) was evaluated on Cardiovascular endpoints (HR 1.37, 95% CI 1.18-1.59). A 1 SD increment in central arterial systolic pressure-time index was associated with an increased risk of cardiovascular endpoints (HR 1.37; 95% CI 1.18-1.59).