Artery Research

Volume 20, Issue C, December 2017, Pages 100 - 100

P24 SEX-SPECIFIC PULSE WAVE VELOCITY CUT-OFFS IMPROVE SURVIVAL ANALYSIS IN PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE

Authors
Christopher C. Mayer1, Bernhard Hametner1, Katy Whitelegg1, Thomas Weber2, Siegfried Wassertheurer1
1Center for Health & Bioresources, AIT Austrian Institute of Technology, Vienna, Austria
2Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.165How to use a DOI?
Abstract

Objectives: There is evidence for sex and age influences on pulse wave velocity (PWV). Guidelines suggest a sex-independent cut-off for PWV. It is not obvious that an age- and blood-pressure-independent cut-off is suitable in different populations [1, 2].

Thus, the aim is to investigate the suitability of sex-independent cut-offs for risk prediction in a high-risk cohort.

Methods: PWV was measured invasively (invPWV; catheter pullback) and non-invasively (non- invPWV; ARCSolver PWV) for patients with suspected CAD at the hospital in Wels- Grieskirchen (Austria). Patients were grouped in four subgroups based on sex and PWV cut-offs (guidelines and sex-specific ones). A combination of myocardial infarction, death, stroke and cardiovascular revascularization served as primary endpoint. Kaplan-Meier curves, logrank test and hazard-ratios were used for survival analysis and receiver-operating-characteristics (ROC) to determine sex-specific cut- offs.

Results: 604 male (61 (11 SD) years) and 324 female (65 (11 SD) years) with a median follow-up of 1576 days and 215 events were included. Logrank test revealed significant differences between Kaplan-Meier curves (p < 0.001), but dichotomized PWV remained just discriminative in women, but not men, for invasive and non- invasive recordings. ROC analysis revealed sex-specific cut-offs of 8.5 m/s (men) or 9.6 m/s (women) for invasive and 8.9 m/s (men) or 10.0 m/s (women) for non- invasive recordings. When using these cut-offs, PWV turned out to be discriminative in both sexes (Table).

HR (≤10m/s vs. >10m/s) Sex-specific cut-off HR (≤ sex-specific cut-off vs. > sex-specific cut-off)
invPWV
Male 1.41 [0.94; 2.11] 8.5 m/s 1.64 [1.15; 2.34]
Female 2.46 [1.58; 3.84] 9.6 m/s 3.28 [2.14; 5.03]
non-invPWV
Male 1.46 [0.99; 2.16] 8.9 m/s 1.73 [1.22; 2.46]
Female 3.20 [2.11; 4.85] 10.0 m/s 3.20 [2.11; 4.85]
Table.

Results of survival and ROC analysis for invasive and non-invasive PWV for male and female. Hazard-ratios (HR) are presented with their 95% confidence intervals.

Conclusion: Sex-specific PWV cut-offs improve survival analysis in patients with suspected CAD. Cut-offs seem to be directly dependent on the prevalence of CAD and thus need further investigation.

Open Access
This is an open access article distributed under the CC BY-NC license.

References

[1]The Reference Values for Arterial Stiffness’ Collaboration, Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’, Eur Heart J, Vol. 31, No. 19, 2010, pp. 2338-2350.
[2]LM Van Bortel, S Laurent, P Boutouyrie, P Chowienczyk, J Cruickshank, T De Backer, et al., Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity, J Hypertens, Vol. 30, No. 3, 2012, pp. 445-448.
Journal
Artery Research
Volume-Issue
20 - C
Pages
100 - 100
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.165How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Christopher C. Mayer
AU  - Bernhard Hametner
AU  - Katy Whitelegg
AU  - Thomas Weber
AU  - Siegfried Wassertheurer
PY  - 2017
DA  - 2017/12/06
TI  - P24 SEX-SPECIFIC PULSE WAVE VELOCITY CUT-OFFS IMPROVE SURVIVAL ANALYSIS IN PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE
JO  - Artery Research
SP  - 100
EP  - 100
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.165
DO  - 10.1016/j.artres.2017.10.165
ID  - Mayer2017
ER  -