Abstract 1319: Prediction of Cardiovascular Events and All-Cause Mortality With Central Hemodynamics: A Meta-Analysis of Longitudinal Studies
Objectives: Central hemodynamic indexes are increasingly recognized as a surrogate end-point for cardiovascular (CV) disease. We conducted this research to calculate quantitative estimates on the predictive value of central pressures and derived indices for CV outcomes and all-cause mortality by meta-analysis of longitudinal studies.
Methods: We identified 11 longitudinal studies that had employed measures of central hemodynamics and had followed 5,648 subjects for a mean follow-up of 45 months.
Results: 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 (left figure⇓), 1.137 (95% CI 1.063–1.215) for a 10 mmHg-increase of central pulse pressure (middle figure⇓), and 1.318 (95% CI 1.093–1.588) for a 10%-increase of central augmentation index (right figure⇓). Furthermore, we found that a 10%-increase of central augmentation index was associated with a RR of 1.384 (95% CI 1.192–1.606) for all-cause mortality. When compared to brachial pulse pressure, central pulse pressure was associated with a higher RR of clinical events, indicating that it has incremental predictive value.
Conclusions: Central hemodynamic indexes are independent predictors of future CV events and all-cause mortality. Augmentation index predicts clinical events independently of peripheral pressures, while central pulse pressure has incremental predictive ability over peripheral pressures.