Aortic Pulse Wave Velocity Improves Cardiovascular Event Prediction An Individual Participant Meta-Analysis of Prospective Observational Data From 17,635 Subjects

被引：1440

作者：

Ben-Shlomo, Yoav ^{[1
]}

Spears, Melissa ^{[1
]}

Boustred, Chris ^{[1
]}

May, Margaret ^{[1
]}

Anderson, Simon G. ^{[2
]}

Benjamin, Emelia J. ^{[3
,4
]}

Boutouyrie, Pierre ^{[5
]}

Cameron, James ^{[6
,7
]}

Chen, Chen-Huan ^{[8
]}

Cruickshank, J. Kennedy ^{[9
,10
]}

Hwang, Shih-Jen ^{[11
]}

Lakatta, Edward G. ^{[12
]}

Laurent, Stephane ^{[5
]}

Maldonado, Joao ^{[13
]}

Mitchell, Gary F. ^{[14
]}

Najjar, Samer S. ^{[12
,15
]}

Newman, Anne B. ^{[16
]}

Ohishi, Mitsuru ^{[17
]}

Pannier, Bruno ^{[18
]}

Pereira, Telmo ^{[19
]}

Vasan, Ramachandran S. ^{[3
,20
]}

Shokawa, Tomoki ^{[21
]}

Sutton-Tyrell, Kim ^{[16
]}

Verbeke, Francis ^{[22
]}

Wang, Kang-Ling ^{[8
]}

Webb, David J. ^{[23
]}

Hansen, Tine Willum ^{[24
,25
]}

Zoungas, Sophia ^{[26
]}

McEniery, Carmel M. ^{[27
]}

Cockcroft, John R. ^{[28
]}

Wilkinson, Ian B. ^{[27
]}

机构：

[1] Univ Bristol, Sch Social & Community Med, Bristol, Avon, England

[2] Univ Manchester, Inst Cardiovasc Sci, Manchester M13 9PL, Lancs, England

[3] NHLBI, Boston, MA USA

[4] Boston Univ, Sch Med, Dept Med, Framingham Heart Study,Cardiol Sect, Boston, MA 02118 USA

[5] Paris Descartes Univ, Hop Europeen Georges Pompidou, AP HP, INSERM U970, Paris, France

[6] MonashHEART, Monash Cardiovasc Res Ctr, Melbourne, Vic, Australia

[7] Monash Univ, Dept Med MMC, Melbourne, Vic 3004, Australia

[8] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan

[9] Kings Coll London, London WC2R 2LS, England

[10] St Thomas & Guys Hosp, Kings Hlth Partners, London, England

[11] NHLBI, Branch Populat Sci, Div Intramural Res, Bethesda, MD 20892 USA

[12] NIA, Lab Cardiovasc Sci, NIH, Baltimore, MD 21224 USA

[13] Inst Invest & Formacao Cardiovasc, Penacova, Portugal

[14] Cardiovasc Engn Inc, Norwood, MA USA

[15] MedStar Heart Res Inst, Washington, DC USA

[16] Ctr Aging & Populat Hlth, Pittsburgh, PA USA

[17] Osaka Univ, Dept Geriatr Med, Osaka, Japan

[18] Ctr Invest Prevent & Clin, Paris, France

[19] Escola Super Tecnol Saude Coimbra, Coimbra, Portugal

[20] Boston Univ, Dept Med, Framingham Heart Study, Boston, MA USA

[21] Hiroshima Univ, Grad Sch Biomed Sci, Dept Mol & Internal Med, Hiroshima, Japan

[22] Ghent Univ Hosp, Dept Nephrol, Ghent, Belgium

[23] Univ Edinburgh, Queens Med Res Inst, Univ BHF Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

[24] Glostrup Cty Hosp, Res Ctr Prevent & Hlth, Glostrup, Denmark

[25] Steno Diabet Ctr, Glostrup, Denmark

[26] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic 3004, Australia

[27] Univ Cambridge, Clin Pharmacol Unit, Cambridge, England

[28] Wales Heart Res Inst, Cardiff, S Glam, Wales

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2014年 / 63卷 / 07期

基金：

美国国家卫生研究院;

关键词：

cardiovascular disease; meta-analysis; prognostic factor; pulse wave velocity; ISOLATED SYSTOLIC HYPERTENSION; INTIMA-MEDIA THICKNESS; CORONARY-HEART-DISEASE; ARTERIAL STIFFNESS; INDEPENDENT PREDICTOR; BLOOD-PRESSURE; TASK-FORCE; ALL-CAUSE; MORTALITY; RISK;

D O I：

10.1016/j.jacc.2013.09.063

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objectives The goal of this study was to determine whether aortic pulse wave velocity (aPWV) improves prediction of cardiovascular disease (CVD) events beyond conventional risk factors. Background Several studies have shown that aPWV may be a useful risk factor for predicting CVD, but they have been underpowered to examine whether this is true for different subgroups. Methods We undertook a systematic review and obtained individual participant data from 16 studies. Study-specific associations of aPWV with CVD outcomes were determined using Cox proportional hazard models and random effect models to estimate pooled effects. Results Of 17,635 participants, a total of 1,785 (10%) had a CVD event. The pooled age-and sex-adjusted hazard ratios (HRs) per 1-SD change in loge aPWV were 1.35 (95% confidence interval [CI]: 1.22 to 1.50; p < 0.001) for coronary heart disease, 1.54 (95% CI: 1.34 to 1.78; p < 0.001) for stroke, and 1.45 (95% CI: 1.30 to 1.61; p < 0.001) for CVD. Associations stratified according to sex, diabetes, and hypertension were similar but decreased with age (1.89, 1.77, 1.36, and 1.23 for age <= 50, 51 to 60, 61 to 70, and > 70 years, respectively; pinteraction < 0.001). After adjusting for conventional risk factors, aPWV remained a predictor of coronary heart disease (HR: 1.23 [95% CI: 1.11 to 1.35]; p < 0.001), stroke (HR: 1.28 [95% CI: 1.16 to 1.42]; p < 0.001), and CVD events (HR: 1.30 [95% CI: 1.18 to 1.43]; p < 0.001). Reclassification indices showed that the addition of aPWV improved risk prediction (13% for 10-year CVD risk for intermediate risk) for some subgroups. Conclusions Consideration of aPWV improves model fit and reclassifies risk for future CVD events in models that include standard risk factors. aPWV may enable better identification of high-risk populations that might benefit from more aggressive CVD risk factor management. (C) 2014 by the American College of Cardiology Foundation

引用

页码：636 / 646

页数：11

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