In patients with metabolic syndrome, cardiovascular events were associated with increased aPWV (HR 1.29), AIx (HR 1.53), and cIMT (HR 1.31), and decreased flow-mediated dilatation (HR 0.83).
Cohort (n=2,728)
Do arterial markers (aPWV, AIx, cIMT, FMD) predict cardiovascular events in middle-aged patients with metabolic syndrome?
In patients with metabolic syndrome, increased carotid intima-media thickness, aortic stiffness, and decreased endothelial function independently predict future cardiovascular events.
Effect estimate: aPWV HR 1.29, AIx HR 1.53, cIMT HR 1.31, FMD HR 0.83 (95% CI aPWV 1.04-1.60, AIx 1.16-2.02, cIMT 1.14-1.50, FMD 0.71-0.97)
p-value: p=aPWV 0.019, AIx 0.003, cIMT <0.001, FMD 0.016
PURPOSE: The objective of this study was to assess predictive value of various arterial markers for cardiovascular (CV) events in patients with metabolic syndrome (MetS). MATERIALS AND METHODS: A longitudinal study with the follow-up period of 3.9 ± 1.7 years investigated 2728 middle-aged (53.9 ± 6.2 years old, 63% women) MetS subjects without overt CV disease. The study cohort was comprised of the participants of the Lithuanian High Cardiovascular Risk primary prevention program. The baseline assessment included the evaluation of brachial flow-mediated dilatation (FMD), carotid intima-media thickness (cIMT), carotid stiffness index, aortic pulse wave velocity (aPWV), aortic augmentation index (AIx), and cardio-ankle vascular index). The data on the cardiovascular outcome (fatal or non-fatal myocardial infarction or stroke) was collected by using the databases of the two major national registries. RESULTS: Over the follow-up period, 83 (3%) patients had at least one cardiovascular event. In a univariate analysis, occurrence of CV events was associated with the following parameters: higher mean blood pressure, aPWV, AIx and cIMT, and lower FMD (all p 794 mcm had higher CV risk (p 11.1 m/s (p = .023). Meanwhile, in patients with cIMT ≤ 794mcm, the FMD cut-off point of 6.5% further stratified the risk (p = .003). CONCLUSIONS: In our prospective study, CV risk in the middle-aged patients with MetS was associated with an increase in cIMT and aPWV, and with a decrease in FMD.
Ryliškytė et al. (Wed,) conducted a cohort in Metabolic syndrome (n=2,728). Arterial markers (aPWV, AIx, cIMT, FMD) was evaluated on Fatal or non-fatal myocardial infarction or stroke (aPWV HR 1.29, AIx HR 1.53, cIMT HR 1.31, FMD HR 0.83, 95% CI aPWV 1.04-1.60, AIx 1.16-2.02, cIMT 1.14-1.50, FMD 0.71-0.97, p=aPWV 0.019, AIx 0.003, cIMT <0.001, FMD 0.016). In patients with metabolic syndrome, cardiovascular events were associated with increased aPWV (HR 1.29), AIx (HR 1.53), and cIMT (HR 1.31), and decreased flow-mediated dilatation (HR 0.83).
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