Abstract 11232: Arterial Stiffness is an Independent Predictor of Cardiac Mortality in Asymptomatic Patients With Intermediate Atherosclerotic Risk Factors
Background: To identify predictors of cardiac death in patients with intermediate atherosclerotic risk patients, we studied the prognostic value of arterial stiffness as measured by Cardio Ankle Vascular Index (CAVI) in these patients.
Methods: We prospectively followed 1,382 asymptomatic patients with intermediate risk factors as assessed by RAMA-EGAT score showing predicted 10-years event rate of 10-20%. RAMA-EGAT Score is a Framingham risk score equivalent but more well-validated in Thai population. These patients were referred for Coronary Computed Tomography Angiography (CTA) for cardiac risk assessment. Patients were followed over 6.9+0.7 years for cardiac death (54 patients). A multivariable Cox regression was performed to identify associations with events.
Results: Event free survival was 96+0.5% at 6 years. Cardiac mortality was predicted by CAVI (Hazard ratio 1.23 [95%CI 1.01-1.54], p = 0.046), independent of traditional risk score validated in our population (RAMA-EGAT Score) (Hazard ratio 1.01 [95% CI 0.95-1.07], p=0.824), presence of significant CAD by Coronary CTA (Hazard ratio 1.19 [95% CI 0.52-2.73], p=0.684) and visceral fat area (Hazard ratio 1.01 [95% CI 1.00-1.01], p=0.073). A mean CAVI > 8 was associated with a significant excess mortality (p=0.011)(Figure a) and this measurement added incremental prognostic value to the clinical risk factors (age, gender, cholesterol, diabetes, hypertension, smoking and waist circumference) and visceral fat area (Figure b).
Conclusion: Arterial stiffness evaluated by Cardio Ankle Vascular Index is not only an independent predictor of cardiac mortality in patients with intermediate atherosclerotic risk factors but also incremental to other clinical and coronary CTA variables.
- © 2013 by American Heart Association, Inc.