P23: Prediction of Total and Cause-Specific Mortality Incidence as Well as Cardiovascular Morbidity by Use of Non-Invasive Measurement of Carotid- Femoral Pulse Wave Velocity as A Measure of Arterial Stiffness

Abstract

Objective

Arterial stiffness (AS) increases with age and predicts total mortality and total cardiovascular (CV) events. It has also been shown that positive family history (FH+) of cardiometabolic disease influences AS. We aimed to: 1) examine if AS predicts total mortality among elderly subjects, as well as total, fatal, and non-fatal CV events; and 2) to assess if FH+ influences the prediction of AS.

Methods

Participants from the Malmö Diet Cancer CV cohort (MDC-CV; n = 3,056, mean age 71 years, 40% men) in Sweden were examined during 2007–2012. AS was measured with carotid-femoral pulse wave velocity (c–f PWV; Sphygmocor®). Follow-up started from date of measurement and ended at death, emigration or on 31^st December 2014. Hazard ratios (HRs) with 95% confidence intervals were computed using multivariable Cox and competing risks regression (sub-hazard ratio, SHR) adjusting for age, sex, cardiovascular risk factors, prevalent cardiometabolic diseases and FH+.

Results

c–f PWV (per log-unit) significantly predicted total mortality, HR 2.57 (95%CI: 1.28–5.16, p = 0.008), after full adjustment for risk factors, and HR3.01 (95%CI: 1.41–6.42) after adding FH. The prediction of CV events was of borderline significance, HR 1.85 (95%CI: 0.91–3.78, p = 0.09). FH+ contribution to c–f PWV prediction of non-CV mortality was of borderline significance SHR 2.30 (95%CI: 0.89–5.95, p = 0.085).

Conclusion

Arterial stiffness (c–f PWV) predicts total mortality, even adjusted for family history. Thus c–f PWV is a promising risk marker for total mortality, beyond the prediction offered by conventional risk factors.