Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul, National University College of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2022 Nov 11;101(45):e31758. doi: 10.1097/MD.0000000000031758.
The prognostic value of arterial stiffness in patients with diabetes mellitus (DM) remains unclear. The aim of this study was to investigate the association between brachial-ankle pulse wave velocity (baPWV) and the occurrence of cardiovascular events in people with DM. A total of 2714 subjects (mean age, 63.6 years; males, 59.3%) with type 2 DM and without documented cardiovascular disease and stroke were analyzed. The primary end-point of this study was composite cardiovascular events of cardiac death, non-fatal myocardial infarction, coronary revascularization and stroke. There were 118 composite events (4.3%) during a median follow-up period of 3.84 years (interquartile range, 1.60-5.52 years). In multivariable Cox regression analysis, higher baPWV (≥1672 cm/s) was associated with composite events even after controlling for potential confounders (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.31-3.07; P = .001). Compared to the lowest baPWV tertile, both middle (HR, 1.84; 95% CI, 1.03-3.27; P = .037) and the highest (HR, 2.97; 95% CI, 1.69-5.22; P < .001) tertile of baPWV were associated with increased risk of cardiovascular events in the same multivariable model. In conclusion, the baPWV was associated with cardiovascular events in people with type 2 DM. Considering the simplicity and convenience of baPWV measurement, baPWV may be useful for risk stratification of people with type 2 DM.
动脉僵硬度对糖尿病(DM)患者的预后价值尚不清楚。本研究旨在探讨肱踝脉搏波速度(baPWV)与 DM 患者发生心血管事件的关系。共分析了 2714 名(平均年龄 63.6 岁;男性 59.3%)无心血管疾病和中风病史的 2 型 DM 患者。本研究的主要终点是心源性死亡、非致死性心肌梗死、冠状动脉血运重建和中风的复合心血管事件。在中位数为 3.84 年(四分位距 1.60-5.52 年)的随访期间,发生了 118 例复合事件(4.3%)。多变量 Cox 回归分析显示,即使在控制了潜在混杂因素后,较高的 baPWV(≥1672cm/s)与复合事件相关(风险比 [HR],2.00;95%置信区间 [CI],1.31-3.07;P=0.001)。与最低 baPWV 三分位相比,中三分位(HR,1.84;95%CI,1.03-3.27;P=0.037)和最高三分位(HR,2.97;95%CI,1.69-5.22;P<0.001)的 baPWV 与心血管事件风险增加相关在相同的多变量模型中。总之,baPWV 与 2 型 DM 患者的心血管事件相关。考虑到 baPWV 测量的简单性和便利性,baPWV 可能有助于 2 型 DM 患者的风险分层。