Unité de Prévention Cardiovasculaire, Service d'Endocrinologie-Métabolisme, Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France; Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), Paris, France.
Atherosclerosis. 2013 Dec;231(2):436-41. doi: 10.1016/j.atherosclerosis.2013.10.004. Epub 2013 Oct 12.
Arterial stiffness is linked to cardiovascular risk and predicts clinical events independently of peripheral blood pressure. The potential relationship between the augmentation index measured at the radial artery and asymptomatic atherosclerosis remains unclear however. In order to assess relationship between the peripheral augmentation index and traditional risk factors, we estimated cardiovascular risk and presence of subclinical atherosclerosis in a large asymptomatic population in primary prevention. Patients in primary prevention (n = 1007) with at least 1 cardiovascular risk factor were included and radial augmentation index was measured. Maximum common carotid intima-media thickness, the presence of plaque and Framingham 10 year cardiovascular risk score were assessed. The mean augmentation index was 81 ± 13% in a population composed of 55% males (mean age 56 years). The augmentation index differed significantly between men (77 ± 12%) and women (86 ± 12%). In the global population, augmentation index was negatively correlated to height and weight, and positively correlated to cardiovascular risk, age, systolic blood pressure, pulse pressure, diabetes, HDL-Cholesterol, fasting glucose, intima-media thickness and to the presence of plaques. Multivariate analysis in the global and in the male population revealed an independent and positive relationship between augmentation index and intima-media thickness on the one hand, and between augmentation index and the presence of plaque on the other. Our results confirm that there are significant relationships between a surrogate marker of arterial stiffness and subclinical atherosclerosis in a large primary prevention population.
动脉僵硬度与心血管风险相关,并可独立于外周血压预测临床事件。然而,桡动脉增强指数与无症状动脉粥样硬化之间的潜在关系尚不清楚。为了评估外周增强指数与传统危险因素之间的关系,我们在一级预防的大量无症状人群中评估了心血管风险和亚临床动脉粥样硬化的存在。在一级预防中纳入了至少有 1 个心血管危险因素的患者(n=1007),并测量了桡动脉增强指数。评估了最大颈总动脉内膜中层厚度、斑块的存在和 Framingham 10 年心血管风险评分。在由 55%男性(平均年龄 56 岁)组成的人群中,平均增强指数为 81±13%。男性(77±12%)和女性(86±12%)之间的增强指数差异显著。在整个人群中,增强指数与身高和体重呈负相关,与心血管风险、年龄、收缩压、脉压、糖尿病、高密度脂蛋白胆固醇、空腹血糖、内膜中层厚度以及斑块的存在呈正相关。在整个人群和男性人群中的多元分析显示,增强指数与内膜中层厚度之间存在独立的正相关,与斑块的存在之间也存在独立的正相关。我们的结果证实,在一个大型一级预防人群中,动脉僵硬度的替代标志物与亚临床动脉粥样硬化之间存在显著的关系。