颈动脉-股动脉脉搏波速度与 SCORE 系统评估的城市波兰人群总体心血管风险评分的相关性。

Association between carotid-femoral pulse wave velocity and overall cardiovascular risk score assessed by the SCORE system in urban Polish population.

机构信息

Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.

Department of Coronary Artery Disease and Heart Failure, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Kardiol Pol. 2019;77(3):363-370. doi: 10.5603/KP.a2019.0028. Epub 2019 Feb 11.

DOI:10.5603/KP.a2019.0028

PMID:30740645

Abstract

BACKGROUND

The Systemic COronary Risk Estimation (SCORE) system is recommended for the assessment of cardiovascular disease (CVD) death risk in individuals free of CVD.

AIM

We sought to determine the association between carotid-femoral pulse wave velocity (CFPWV) and SCORE.

METHODS

The study involved 1008 Krakow residents, and a random subsample of 3424 men and 3205 women who participated in Wave 2 of the Polish part of the Health, Alcohol, and Psychosocial factors in Eastern Europe (HAPIEE) study. At baseline we performed a medical interview, physical examination, evaluation of present comorbidities, medications using standardised methods. A follow-up of 4.9 years included measurement of CFPWV using an automatic, computerised Complior® system.

RESULTS

Final analysis included 720 patients (378 women), aged 58.5 ± 6.5 years at baseline. In 488 individuals without his- tory of CVD and/or diabetes, SCORE was calculated. Median CFPWV was higher (p = 0.002) in men (12.5 m/s; interquartile range [IQR] 10.3-15.7) than in women (11.7 m/s; IQR 10.1-13.7). High CFPWV (> 10 m/s) was observed in 270 men (78.9%) and in 285 women (75.4%). We observed a strong association between high CVD risk (SCORE ≥ 5%) and high CFPWV (odds ratio 2.29; 95% confidence interval 1.17-4.46). The CFPWV cut-off value to differentiate between patients with low and high CVD risk was 11.7 m/s (with 58.6% sensitivity and 71.3% specificity, AUC = 0.68).

CONCLUSIONS

Our study is the first to describe the distribution of CFPWV in the adult Polish population. SCORE ≥ 5% pre- dicted high CFPWV in 4.9 years of follow-up, which was independent of other risk factors. CFPWV > 11.7 m/s was most valid in relation to high CVD risk.

摘要

背景

系统性冠状动脉风险评估（SCORE）系统被推荐用于评估无心血管疾病（CVD）个体的 CVD 死亡风险。

目的

我们旨在确定颈股脉搏波速度（CFPWV）与 SCORE 之间的关系。

方法

该研究纳入了 1008 名克拉科夫居民，其中随机抽取了 3424 名男性和 3205 名女性参加了波兰部分的健康、酒精和东欧心理社会因素（HAPIEE）研究的第 2 波。在基线时，我们进行了医学访谈、体检、评估当前合并症、使用标准化方法评估药物。4.9 年的随访包括使用自动、计算机化的 Complior®系统测量 CFPWV。

结果

最终分析包括 720 名患者（378 名女性），基线时年龄为 58.5±6.5 岁。在 488 名无 CVD 和/或糖尿病病史的个体中，计算了 SCORE。男性的 CFPWV 中位数较高（p=0.002）（12.5m/s；四分位距[IQR]10.3-15.7），女性的 CFPWV 中位数较低（11.7m/s；IQR 10.1-13.7）。270 名男性（78.9%）和 285 名女性（75.4%）存在高 CFPWV（>10m/s）。我们观察到高 CVD 风险（SCORE≥5%）与高 CFPWV 之间存在很强的关联（比值比 2.29；95%置信区间 1.17-4.46）。区分低和高 CVD 风险患者的 CFPWV 截断值为 11.7m/s（敏感性为 58.6%，特异性为 71.3%，AUC=0.68）。