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A Vascular Aging Index as Independent Predictor of Cardiovascular Events and Total Mortality in an Elderly Urban Population

Nilsson Wadström, Benjamin; Fatehali, Abd al Hakim; Engström, Gunnar LU and Nilsson, Peter M. LU (2019) In Angiology
Abstract

The morphology and function of the arteries can be directly measured using different established methods. This prospective cohort study aimed to translate 2 of these, aortic pulse wave velocity (aPWV) and carotid intima–media thickness (cIMT), into a combined Vascular Aging Index (VAI) and then evaluate the predictive power of aPWV, cIMT, and VAI. Patients (n = 2718) were included from the cardiovascular arm of the Malmö Diet and Cancer Study (median age 71.9 years, 62.2% females). Total follow-up time was 16 448 person-years and a composite cardiovascular disease (CVD) end point was used. Cox regressions yielded adjusted hazard ratios (95% confidence interval) per 1 standard deviation increment of loge aPWV, loge... (More)

The morphology and function of the arteries can be directly measured using different established methods. This prospective cohort study aimed to translate 2 of these, aortic pulse wave velocity (aPWV) and carotid intima–media thickness (cIMT), into a combined Vascular Aging Index (VAI) and then evaluate the predictive power of aPWV, cIMT, and VAI. Patients (n = 2718) were included from the cardiovascular arm of the Malmö Diet and Cancer Study (median age 71.9 years, 62.2% females). Total follow-up time was 16 448 person-years and a composite cardiovascular disease (CVD) end point was used. Cox regressions yielded adjusted hazard ratios (95% confidence interval) per 1 standard deviation increment of loge aPWV, loge cIMT, and loge VAI of 1.25 (1.08-1.45, P =.003), 1.27 (1.13-1.44, P <.001), and 1.45 (1.26-1.68, P <.001), respectively. The C-statistics increased from 0.714 to 0.734 when adding aPWV and cIMT to a model of conventional risk factors. Net Reclassification Index also showed a significant (P <.001) improvement for the classification of event-free patients and no change for patients with events. A VAI based on aPWV and cIMT had a good predictive performance. Used together, aPWV and cIMT incrementally and significantly improve the prediction of CVD events by correctly down-adjusting the predicted risk for noncases.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
arterial stiffness, arteriosclerosis, cardiovascular, elderly, epidemiology, intima–media thickness, prediction, pulse wave velocity, Vascular Aging Index
in
Angiology
publisher
SAGE Publications Inc.
external identifiers
  • scopus:85068252748
ISSN
0003-3197
DOI
10.1177/0003319719857270
language
English
LU publication?
yes
id
92f669bb-b59e-4dd0-bc61-4ee0b29b5967
date added to LUP
2019-07-10 11:35:24
date last changed
2019-08-06 03:24:04
@article{92f669bb-b59e-4dd0-bc61-4ee0b29b5967,
  abstract     = {<p>The morphology and function of the arteries can be directly measured using different established methods. This prospective cohort study aimed to translate 2 of these, aortic pulse wave velocity (aPWV) and carotid intima–media thickness (cIMT), into a combined Vascular Aging Index (VAI) and then evaluate the predictive power of aPWV, cIMT, and VAI. Patients (n = 2718) were included from the cardiovascular arm of the Malmö Diet and Cancer Study (median age 71.9 years, 62.2% females). Total follow-up time was 16 448 person-years and a composite cardiovascular disease (CVD) end point was used. Cox regressions yielded adjusted hazard ratios (95% confidence interval) per 1 standard deviation increment of log<sub>e</sub> aPWV, log<sub>e</sub> cIMT, and log<sub>e</sub> VAI of 1.25 (1.08-1.45, P =.003), 1.27 (1.13-1.44, P &lt;.001), and 1.45 (1.26-1.68, P &lt;.001), respectively. The C-statistics increased from 0.714 to 0.734 when adding aPWV and cIMT to a model of conventional risk factors. Net Reclassification Index also showed a significant (P &lt;.001) improvement for the classification of event-free patients and no change for patients with events. A VAI based on aPWV and cIMT had a good predictive performance. Used together, aPWV and cIMT incrementally and significantly improve the prediction of CVD events by correctly down-adjusting the predicted risk for noncases.</p>},
  author       = {Nilsson Wadström, Benjamin and Fatehali, Abd al Hakim and Engström, Gunnar and Nilsson, Peter M.},
  issn         = {0003-3197},
  keyword      = {arterial stiffness,arteriosclerosis,cardiovascular,elderly,epidemiology,intima–media thickness,prediction,pulse wave velocity,Vascular Aging Index},
  language     = {eng},
  publisher    = {SAGE Publications Inc.},
  series       = {Angiology},
  title        = {A Vascular Aging Index as Independent Predictor of Cardiovascular Events and Total Mortality in an Elderly Urban Population},
  url          = {http://dx.doi.org/10.1177/0003319719857270},
  year         = {2019},
}