Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis

被引:1078
作者
Vlachopoulos, Charalambos [1 ]
Aznaouridis, Konstantinos [1 ]
O'Rourke, Michael F. [2 ,3 ]
Safar, Michel E. [4 ]
Baou, Katerina [1 ]
Stefanadis, Christodoulos [1 ]
机构
[1] Hippokrateion Hosp, Athens Med Sch, Dept Cardiol 1, Peripheral Vessels Unit, Athens 14575, Greece
[2] Victor Chang Cardiac Res Inst, St Vincents Clin, Sydney, NSW, Australia
[3] Univ New S Wales, Sydney, NSW, Australia
[4] Hop Hotel Dieu, Diag & Therapeut Ctr, F-75181 Paris, France
关键词
Arterial stiffness; Augmentation index; Cardiovascular risk; Central pressure; Hypertension; Meta-analysis; Prediction; Wave reflections; ARTERIAL WAVE REFLECTIONS; CENTRAL BLOOD-PRESSURE; CENTRAL PULSE PRESSURE; LOW-DOSE COMBINATION; AORTIC PRESSURE; PERINDOPRIL/INDAPAMIDE; RESTENOSIS; REDUCTION; STIFFNESS; AGE;
D O I
10.1093/eurheartj/ehq024
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To calculate robust quantitative estimates on the predictive value of central pressures and derived central haemodynamic indices for cardiovascular (CV) outcomes and all-cause mortality by meta-analysis of longitudinal studies. We meta-analysed 11 longitudinal studies that had employed measures of central haemodynamics and had followed 5648 subjects for a mean follow-up of 45 months. The age- and risk-factor-adjusted pooled relative risk (RR) of total CV events was 1.088 (95% CI 1.040-1.139) for a 10 mmHg increase of central systolic pressure, 1.137 (95% CI 1.063-1.215) for a 10 mmHg increase of central pulse pressure (PP), and 1.318 (95% CI 1.093-1.588) for a 10% absolute increase of central augmentation index (AIx). Furthermore, we found that a 10% increase of central AIx was associated with a RR of 1.384 (95% CI 1.192-1.606) for all-cause mortality. When compared with brachial PP, central PP was associated with marginally but not significantly higher RR of clinical events (P = 0.057). Central haemodynamic indexes are independent predictors of future CV events and all-cause mortality. Augmentation index predicts clinical events independently of peripheral pressures, while central PP has a marginally but not significantly (P = 0.057) better predictive ability when compared with peripheral PP.
引用
收藏
页码:1865 / 1871
页数:7
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