Zhong Qi, Hu Ming-Jun, Cui Yan-Jie, Liang Ling, Zhou Meng-Meng, Yang Yu-Wei, Huang Fen
1 Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China.
Angiology. 2018 Aug;69(7):617-629. doi: 10.1177/0003319717742544. Epub 2017 Nov 26.
Arterial stiffness (AS) is a predictor of coronary artery outcomes in patients with cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cf-PWV) is a commonly used method for assessing AS. This study aimed to assess the relationship between cf-PWV and clinical CVD events. Of the 786 studies identified, 19 studies were included in the final meta-analysis. Meta-analysis revealed that participants with high cf-PWV by 1 standard deviation (SD), 1 m/s, and cutoff points have a high pooled relative risk for CVD events (1 SD: 1.25, 95% confidence interval [CI]: 1.19-1.31; 1 m/s: 1.12, 95% CI: 1.07-1.18; and cutoff points: 1.80, 95% CI: 1.45-2.14) and CVD mortality (1 SD: 1.23, 95% CI: 1.15-1.31; 1 m/s: 1.09, 95% CI: 1.04-1.14; and cutoff points: 1.85, 95% CI: 1.46-2.24). In addition, we found that the predictive value of increased AS was higher in patients with higher disease risk for total CVD events and CVD mortality than in other patients. Carotid-femoral pulse wave velocity is a useful biomarker to improve the prediction of CV risk for patients and identify high-risk populations who may benefit from aggressive CV risk factor management.
动脉僵硬度(AS)是心血管疾病(CVD)患者冠状动脉预后的一个预测指标。颈股脉搏波速度(cf-PWV)是评估AS的常用方法。本研究旨在评估cf-PWV与临床CVD事件之间的关系。在检索到的786项研究中,最终纳入荟萃分析的有19项研究。荟萃分析显示,cf-PWV高于1个标准差(SD)、1 m/s以及高于切点的参与者发生CVD事件的合并相对风险较高(1个标准差:1.25,95%置信区间[CI]:1.19 - 1.31;1 m/s:1.12,95% CI:1.07 - 1.18;切点:1.80,95% CI:1.45 - 2.14),发生CVD死亡的合并相对风险也较高(1个标准差:1.23,95% CI:1.15 - 1.31;1 m/s:1.09,95% CI:1.04 - 1.14;切点:1.85,95% CI:1.46 - 2.24)。此外,我们发现,对于总的CVD事件和CVD死亡,AS升高在疾病风险较高的患者中的预测价值高于其他患者。颈股脉搏波速度是一种有用的生物标志物,可改善对患者心血管风险的预测,并识别可能从积极的心血管危险因素管理中获益的高危人群。