J Korean Med Sci.  2023 Dec;38(50):e414. 10.3346/jkms.2023.38.e414.

Prognostic Value of Brachial-Ankle Pulse Wave Velocity According to Subjects’ Clinical Characteristics: Data From Analysis of 10,597 Subjects

• Kim HL
• Lee KS
• Joh HS
• Lim WH
• Seo JB
• Kim SH
• Zo JH
• Kim MA

• KMID: 2549958
• DOI: http://doi.org/10.3346/jkms.2023.38.e414

Abstract

Background
To make good use of the prognostic value of arterial stiffness, it is important to identify the population with the greatest benefit. In this study, we compared the prognostic value of brachial-ankle pulse wave velocity (baPWV) according to various clinical characteristics.
Methods
A total of 10,597 subjects who underwent baPWV measurement (mean age, 61.4 ± 9.5 years; female proportion, 42.5%) were retrospectively analyzed. Major adverse cardiovascular events (MACEs), defined as a composite of cardiac death, non-fatal myocardial infarction, coronary revascularization, and ischemic stroke were assessed during the clinical follow-up period.
Results
In the multivariate analysis, clinical variables with more than 4,000 subjects were selected as grouping variables, which were sex (men and women), age (≥ 65 and < 65 years), body mass index (BMI) (≥ 25 and < 25 kg/m ²), hypertension (presence and absence), estimated glomerular filtration rate (≥ 90 and < 90 mL/min/1.73 m ² ), and statin use (user and non-user). During the median clinical follow-up duration of 3.58 years (interquartile range, 1.43–5.38 years), there were 422 MACEs (4.0%). In total study subjects, baseline higher baPWV was associated with increased risk of MACE occurrence (hazard ratio for baPWV ≥ 1,800 cm/s compared to baPWV < 1,400 cm/s, 4.04; 95% confidence interval, 2.62–6.21; P < 0.001). The prognostic value of baPWV was statistically significant regardless of sex, age, BMI, hypertension, renal function, and statin use.
Conclusion
Our results suggest that baPWV is not only effective in specific clinical situations, but can be effectively applied to predict cardiovascular prognosis in various clinical situations.

Keyword

Major Adverse Cardiovascular Event; Pulse Wave Velocity; Prognosis; Risk Factors; Risk Stratification

Figure

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  Fig. 1 Major adverse cardiovascular event-free survival rate according to baseline baPWV tertile.baPWV = brachial-ankle pulse wave velocity.

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  Fig. 2 Incremental prognostic value of baPWV to traditional risk factors.baPWV = brachial-ankle pulse wave velocity.aIncluded hypertension, diabetes mellitus, dyslipidemia, cigarette smoking and obesity.

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