P1.41 Could Measurement of Arterial Stiffness Provide Better Approach in Risk Assessment than the Conventional Risk Factor-Based Stratification?

Abstract

Although traditional risk factors may account for 90% of the attributable cardiovascular risk their prediction of CVD is weak based on SCORE Chart. We need to find new established risk factors and to detect subclinical arterial disease to predict future coronary events. Stiffening of the aorta is one of the earliest surrogate marker of vascular damage and measurement of arterial stiffness has a growing interest in risk assessment. Aim: Authors investigated the correlation between the high risk state characterized by SCORE >=5% and elevated aortic pulse wave velocity (PWVao, increased arterial stiffness) measured by arteriograph.

Subject and Methods

2243 adults were included to the analysis in which SCORE could be calculated. Sensitivity, specificity and predictive values of SCORE in detecting increased PWVao were calculated by SPSS software.

Results

Elevated PWVao (>9,62 m/s) was detected in 38% of patient population but sensitivity of SCORE high risk category (> =5%) to detect elevated PWV was poor (33%) despite high specificity (88%) while false negative cases were in 26%. Sensitivity of SCORE was a little bit better in males (65%) but much poorer in females (17%). 10% of males and 36% of females are underestimated by SCORE assessment. The ROC curve of SCORE at the cut-off value of 5% has shown 33% sensitivity but 89% specificity.

Conclusions

If PWVao is a good surrogate of preclinical atherosclerosis SCORE risk assessment seems to be quiet acceptible in men but not in women because it markedly underestimates females CV risk.