Noninvasive peripheral vascular function, incident cardiovascular disease, and mortality in the general population
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Noninvasive peripheral vascular function, incident cardiovascular disease, and mortality in the general population. / Schnabel, Renate B; Magnussen, Christina; Schulz, Andreas; Ojeda, Francisco M; Schmitt, Volker H; Arnold, Natalie; Sinning, Christoph R; Beutel, Manfred E; Schmidtmann, Irene; Pfeiffer, Norbert; Leuschner, Anja; Lackner, Karl J; Gori, Tommaso; Benjamin, Emelia J; Binder, Harald; Wild, Philipp S; Blankenberg, Stefan; Münzel, Thomas; Gutenberg Health Study investigators.
in: CARDIOVASC RES, Jahrgang 118, Nr. 3, 21.02.2022, S. 904-912.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Noninvasive peripheral vascular function, incident cardiovascular disease, and mortality in the general population
AU - Schnabel, Renate B
AU - Magnussen, Christina
AU - Schulz, Andreas
AU - Ojeda, Francisco M
AU - Schmitt, Volker H
AU - Arnold, Natalie
AU - Sinning, Christoph R
AU - Beutel, Manfred E
AU - Schmidtmann, Irene
AU - Pfeiffer, Norbert
AU - Leuschner, Anja
AU - Lackner, Karl J
AU - Gori, Tommaso
AU - Benjamin, Emelia J
AU - Binder, Harald
AU - Wild, Philipp S
AU - Blankenberg, Stefan
AU - Münzel, Thomas
AU - Gutenberg Health Study investigators
N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2022/2/21
Y1 - 2022/2/21
N2 - AIMS : Evidence suggests that peripheral vascular function is related to cardiovascular disease (CVD) and mortality. We evaluated the associations of non-invasive measures of flow-mediated dilatation and peripheral arterial tonometry with incident CVD and mortality.METHODS AND RESULTS : In a post-hoc analysis of the community-based Gutenberg Health Study, median age 55 years (25th/75th percentile 46/65) and 49.5% women, we measured brachial artery flow-mediated dilatation (N=12 599) and fingertip peripheral arterial tonometry (N=11 125). After a follow-up of up to 11.7 years, we observed 595 incident CVD events, 106 cardiac deaths, and 860 deaths in total. Survival curves showed decreased event-free survival with higher mean brachial artery diameter and baseline pulse amplitude and better survival with higher mean flow-mediated dilatation and peripheral arterial tonometry ratio (all Plog rank <0.05). In multivariable-adjusted Cox regression analyses only baseline pulse amplitude was inversely related to mortality [hazard ratio (HR) per standard deviation increase, 0.86, 95% confidence interval (95% CI), 0.79-0.94; P=0.0009]. After exclusion of individuals with prevalent CVD the association was no longer statistically significant in multivariable-adjusted models (HR 0.91, 95% CI 0.81-1.02; P=0.11). None of the vascular variables substantially increased the C-index of a model comprising clinical risk factors.CONCLUSIONS : In our cohort, non-invasive measures of peripheral vascular structure and function did not reveal clinically relevant associations with incident CVD or mortality. Whether determination of pulse amplitude by peripheral arterial tonometry improves clinical decision-making in primary prevention needs to be demonstrated.
AB - AIMS : Evidence suggests that peripheral vascular function is related to cardiovascular disease (CVD) and mortality. We evaluated the associations of non-invasive measures of flow-mediated dilatation and peripheral arterial tonometry with incident CVD and mortality.METHODS AND RESULTS : In a post-hoc analysis of the community-based Gutenberg Health Study, median age 55 years (25th/75th percentile 46/65) and 49.5% women, we measured brachial artery flow-mediated dilatation (N=12 599) and fingertip peripheral arterial tonometry (N=11 125). After a follow-up of up to 11.7 years, we observed 595 incident CVD events, 106 cardiac deaths, and 860 deaths in total. Survival curves showed decreased event-free survival with higher mean brachial artery diameter and baseline pulse amplitude and better survival with higher mean flow-mediated dilatation and peripheral arterial tonometry ratio (all Plog rank <0.05). In multivariable-adjusted Cox regression analyses only baseline pulse amplitude was inversely related to mortality [hazard ratio (HR) per standard deviation increase, 0.86, 95% confidence interval (95% CI), 0.79-0.94; P=0.0009]. After exclusion of individuals with prevalent CVD the association was no longer statistically significant in multivariable-adjusted models (HR 0.91, 95% CI 0.81-1.02; P=0.11). None of the vascular variables substantially increased the C-index of a model comprising clinical risk factors.CONCLUSIONS : In our cohort, non-invasive measures of peripheral vascular structure and function did not reveal clinically relevant associations with incident CVD or mortality. Whether determination of pulse amplitude by peripheral arterial tonometry improves clinical decision-making in primary prevention needs to be demonstrated.
U2 - 10.1093/cvr/cvab087
DO - 10.1093/cvr/cvab087
M3 - SCORING: Journal article
C2 - 33724298
VL - 118
SP - 904
EP - 912
JO - CARDIOVASC RES
JF - CARDIOVASC RES
SN - 0008-6363
IS - 3
ER -