Augmentation index is a better marker for cardiovascular risk in young Malaysian males. A comparison of involvement of pulse wave velocity, augmentation index, and C-reactive protein

OBJECTIVE: To determine the association between carotid femoral pulse wave velocity (PWVCF) and augmentation index (AI) with future cardiovascular disease (CVD) risk, and to assess whether high sensitivity C-reactive protein (hs-CRP) is an important mediator towards these vascular changes, among young men. METHODS: This cross-sectional study was conducted at Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia from July 2011 to December 2012. Two hundred and eleven young men were recruited. The PWVCF and AI were measured using Vicorder. High sensitivity C-reactive protein was measured by using immunological methods. The future CVD risk was assessed by Framingham risk score (FRS) and age adjusted FRS (A-FRS). Data for analysis was conducted using the Statistical Package for Social Sciences Version 15 (SPSS Inc., Chicago, IL, USA). RESULTS: The mean age of the subjects was 27.09 (95% confidence intervals [CI] 26.39-27.79) years old. Those with ≥2 risk factors had significantly higher AI [10.09 (95% CI: 9.06-11.12) versus 6.56 (95% CI: 5.54-7.57) (p=0.001), but not PWVCF 7.45 (95% CI: 7.29-7.61) m/s versus 7.29 (95% CI: 7.06-7.51) m/s, (p=0.90) when compared to the healthy subjects. High sensitivity C-reactive protein was not an independent determinant for PWVCF and AI. Only AI was significantly associated with FRS and A-FRS (p=0.0001). CONCLUSION: To assess the impact of risk factors on vascular damage and for future assessment of CVD risk among the young men, AI may be a better marker than PWVCF. The increase in AI among these subjects was not related to hs-CRP.