Ji Chunpeng, Wu Shouling, Huang Zhe, Zhu Chenrui, Cui Wei
Department of Cardiology, Kailuan General Hospital, Tangshan, China.
Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Anatol J Cardiol. 2024 Aug 3;28(10):486-92. doi: 10.14744/AnatolJCardiol.2024.4262.
The oscillometrically measured ankle-brachial index (omABI), which is determined by the ratio of ankle to brachial systolic blood pressure measured through oscillography, has been demonstrated as a robust predictor of cardiovascular events. However, the reliability of mean arterial pressure measured by oscillography may be higher than that of systolic blood pressure based on the principle of oscillographic oscillation. We aimed to compare the predictive value of oscillometrically measured ankle-tobrachial mean arterial pressure ratio (omMAPR) and omABI for cardiovascular events and all-cause mortality.
The observation cohort consisted of a total of 37 803 employees from the Chinese Kailuan Group who underwent limb blood pressure measurements during their participation in physical examination between 2010 and 2017.
After an average follow-up period of 3 years, a total of 589 cardiovascular events and 570 cases of all-cause mortality were observed. The predictive performance of omMAPR was found to be slightly superior to omABI in terms of cardiovascular events (C-statistics: 0.55 vs. 0.51, P < .001) and all-cause mortality (C-statistics: 0.60 vs. 0.55, P <.001). After adjusting for confounders, within a specific range (omMAPR ≤ 1.06 or omABI ≤ 1.12), each 0.1-unit increase in omMAPR was associated with reductions of 14% (HR = 0.86, 95% CI: 0.77-0.96) and 23% (HR = 0.77, 95% CI: 0.70-0.84) in cardiovascular events and all cause mortality, respectively, while each 0.1-unit increase in omABI was associated with reductions of 12% (HR = 0.88, 95% CI: 0.79-0.97) and 22% (HR = 0.78, 95% CI: 0.72-0.85) in cardiovascular events and all-cause mortality, respectively. However, once out of that range (omMAPR > 1.06 or omABI > 1.12), neither omMAPR nor omABI was significantly associated with cardiovascular events or all-cause mortality.
Both omMAPR and omABI within specific ranges (omMAPR ≤ 1.06 or omABI ≤ 1.12) were independent predictors for cardiovascular events and all-cause mortality. Moreover, omMAPR exhibited a slightly superior predictive ability compared to omABI in relation to cardiovascular events and all-cause mortality. The trial registration number is ChiCTR-TNRC-11001489.
通过示波法测量的踝臂指数（omABI），由通过示波法测量的踝部与臂部收缩压之比确定，已被证明是心血管事件的可靠预测指标。然而，基于示波振荡原理，示波法测量的平均动脉压的可靠性可能高于收缩压。我们旨在比较示波法测量的踝臂平均动脉压比（omMAPR）和omABI对心血管事件和全因死亡率的预测价值。
观察队列包括中国开滦集团的37803名员工，他们在2010年至2017年参加体检期间进行了四肢血压测量。
平均随访3年后，共观察到589例心血管事件和570例全因死亡病例。在心血管事件（C统计量：0.55对0.51，P <.001）和全因死亡率（C统计量：0.60对0.55，P <.001）方面，发现omMAPR的预测性能略优于omABI。在调整混杂因素后，在特定范围内（omMAPR≤1.06或omABI≤1.12），omMAPR每增加0.1个单位，心血管事件和全因死亡率分别降低14%（HR = 0.86，95%CI：0.77 - 0.96）和23%（HR = 0.77，95%CI：0.70 - 0.84），而omABI每增加0.1个单位，心血管事件和全因死亡率分别降低12%（HR = 0.88，95%CI：0.79 - 0.97）和22%（HR = 0.78，95%CI：0.72 - 0.85）。然而，一旦超出该范围（omMAPR > 1.06或omABI > 1.12），omMAPR和omABI均与心血管事件或全因死亡率无显著关联。
特定范围内（omMAPR≤1.06或omABI≤1.12）的omMAPR和omABI均是心血管事件和全因死亡率的独立预测指标。此外，在心血管事件和全因死亡率方面，omMAPR的预测能力略优于omABI。试验注册号为ChiCTR - TNRC - 11001489。
