Higher oscillometric aortic pulse wave velocity predicted an increased 10-year risk of major adverse cardiovascular events (HR per SD 1.22; 95% CI 1.03-1.45).
Cohort (n=9,973)
Does oscillometric aortic pulse wave velocity predict major adverse cardiovascular events in a multiethnic urban population without pre-existing cardiovascular disease?
Oscillometric pulse wave velocity predicts long-term major adverse cardiovascular events and improves cardiovascular risk prediction in a multiethnic urban population.
Hazard Ratio: 1.22 (95% CI 1.03–1.45)
Absolute Event Rate: 4.5% vs 0.4%
p-value: p=<0.001
Objective: Aortic pulse wave velocity (PWV) reflects arterial stiffness and reliably predicts future cardiac events. Carotid-femoral PWV (cfPWV), measured by tonometry, is considered the gold-standard, but its widespread clinical use is limited by technical and operator-dependent challenges. Oscillometric cuff-based devices provide a simpler alternative, yet their prognostic value remains unclear. We aimed to evaluate the prognostic implications of oscillometric PWV for major adverse cardiovascular events (MACE) in a large multi-ethnic urban population. Design and method: We included 9,973 participants without pre-existing cardiovascular diseases at baseline from the Healthy Life in an Urban Setting (HELIUS) study with outcomes linked to national registry data. Ten-year incidence of MACE (unstable angina, non-fatal myocardial infarction, non-fatal stroke, cardiovascular death) and MACE + non-cardiovascular death was estimated by Kaplan–Meier analysis across PWV tertiles. Next, Cox-regression analysis adjusted for age, sex and traditional cardiovascular risk factors was used to study the association between log-transformed oscillometric PWV (logPWV) and long-term MACE outcomes. Predictive performance was evaluated by comparing models with and without PWV using Harrell's C-statistic, integrated discrimination improvement (IDI), and category-free net reclassification improvement (cfNRI). Results: At 10-year follow up the KM estimates of MACE outcomes were significantly different between tertile groups (MACE: tertile 1 (0.4%, 95%-CI: 0.3%, 0.8%) vs. tertile 2 (2.2%, 95%-CI: 1.7%, 2.8%) vs. tertile 3 (4.5%, 95%-CI: 3.8%, 5.3%), log-rank p<0.001); MACE + non-CVD death: tertile 1 (1.1%, 95%-CI: 0.8%, 1.6%) vs. tertile 2 (3.6%, 95%-CI: 3.0%, 4.5%) vs. tertile 3 (9.0%, 95%-CI: 7.9%, 10.1%), log-rank p<0.001). Median follow-up was 110 months (Q1, Q3: 102, 119). logPWV was significantly associated with long-term MACE (HR per SD logPWV 1.22 (95%-CI: 1.03, 1.45) and MACE + non-CVD death (HR per SD logPWV 1.17 (95%-CI: 1.04, 1.33). The HRs for MACE + non-CVD death did not differ significantly across sex, age groups or ethnic groups. Adding logPWV to prediction models showed significant, albeit modest, improved risk estimation and reclassification for 10-year MACE outcomes.Conclusions: Oscillometric PWV predicts MACE outcomes in a multiethnic urban population and adds to CVD risk prediction.
Wijntjens et al. (Fri,) conducted a cohort in No pre-existing cardiovascular diseases (n=9,973). Oscillometric aortic pulse wave velocity vs. Lower pulse wave velocity (tertile 1) was evaluated on Major adverse cardiovascular events (unstable angina, non-fatal myocardial infarction, non-fatal stroke, cardiovascular death) (HR 1.22, 95% CI 1.03, 1.45, p=<0.001). Higher oscillometric aortic pulse wave velocity predicted an increased 10-year risk of major adverse cardiovascular events (HR per SD 1.22; 95% CI 1.03-1.45).