Department of Cardiology, The PLA Navy Anqing Hospital, Anqing, Anhui, China.
School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
BMC Cardiovasc Disord. 2022 Jan 12;22(1):9. doi: 10.1186/s12872-022-02456-5.
Aortic stiffness and coronary heart disease (CHD) share a similar spectrum of risk factors; previous studies have identified the association between aortic stiffness and CHD. Recent studies have demonstrated estimated pulse wave velocity (ePWV) as a simple and easy-acquired indicator of aortic stiffness. Our work aims to evaluate the association between ePWV and the prevalence of CHD and assess the value of ePWV for the identification of prevalent CHD.
The current cross-sectional work included 7012 subjects from rural areas of southeastern China between September 2020 and February 2021. ePWV was calculated from age and mean blood pressure by specific algorithm.
The prevalence of CHD in our population was 3.58% (251 patients among 7012 subjects). After adjusting for age, sex, education, income and exercise level, current smoking and drinking status, body mass index, waist circumference, fasting plasma glucose, total cholesterol, high density lipoprotein, estimated glomerular filtration rate and cerebrovascular diseases, each standard deviation increment of ePWV would produce an additional 37.8% risk of prevalent CHD. Moreover, after dividing ePWV into quartiles, the 4th quartile of ePWV showed a significant risk of prevalent CHD (OR (95% CI): 3.567 (1.963-6.479)) when compared with the 1 quartile. Additionally, the subgroup analysis showed the association between ePWV and prevalent CHD was robust to several common risk factors of CHD, including age, sex, body mass index, hypertension, diabetes and reduced estimated glomerular filtration rate. Finally, the area under curve (AUC) displayed an improvement when adding ePWV into common CHD risk factors (0.705 vs. 0.718. P = 0.044). Consistently, net reclassification index (0.436, 95% CI: 0.301-0.571, P < 0.001) and integrated discrimination index (0.004, 95% CI: 0.001-0.006, P = 0.002) demonstrated the value of ePWV to optimize the identification of prevalent CHD in the general population.
The present analysis implicates the robust association between ePWV, a simple, rapid, and practical marker of aortic stiffness, and prevalent CHD in the general Chinese population. More importantly, the results suggest the value of ePWV as a potential marker to improve the identification of prevalent CHD.
主动脉僵硬和冠心病（CHD）具有相似的危险因素谱；先前的研究已经确定了主动脉僵硬与 CHD 之间的关联。最近的研究表明，估算脉搏波速度（ePWV）是一种简单易用的主动脉僵硬指标。我们的工作旨在评估 ePWV 与 CHD 患病率之间的关联，并评估 ePWV 对识别 CHD 患病率的价值。
本横断面研究纳入了 2020 年 9 月至 2021 年 2 月期间中国东南部农村地区的 7012 名受试者。通过特定算法从年龄和平均血压计算 ePWV。
我们人群中的 CHD 患病率为 3.58%（7012 名受试者中有 251 名患者）。在校正年龄、性别、教育程度、收入和运动水平、当前吸烟和饮酒状况、体重指数、腰围、空腹血糖、总胆固醇、高密度脂蛋白、估算肾小球滤过率和脑血管疾病后，ePWV 每增加一个标准差，CHD 患病率的风险就会增加 37.8%。此外，将 ePWV 分为四分位后，第 4 四分位的 ePWV 与第 1 四分位相比，CHD 患病率的风险显著增加（OR（95%CI）：3.567（1.963-6.479））。此外，亚组分析显示，ePWV 与 CHD 患病率之间的关联在包括年龄、性别、体重指数、高血压、糖尿病和估算肾小球滤过率降低在内的几种 CHD 常见危险因素中是稳健的。最后，曲线下面积（AUC）显示，在将 ePWV 添加到常见 CHD 危险因素中后有所改善（0.705 与 0.718，P=0.044）。一致地，净重新分类指数（0.436，95%CI：0.301-0.571，P<0.001）和综合判别指数（0.004，95%CI：0.001-0.006，P=0.002）表明 ePWV 有价值，可以优化一般人群中 CHD 患病率的识别。
本分析表明，在一般中国人群中，ePWV 作为一种简单、快速和实用的主动脉僵硬标志物，与 CHD 患病率之间存在稳健关联。更重要的是，结果表明 ePWV 作为一种潜在标志物，有助于提高 CHD 患病率的识别。
