P69 Relationship Between Carotid Intima-Media Thickness, Endothelial Function, Aortic Stiffness and Cardiovascular Events Among Metabolic Syndrome Subjects

Abstract

Objective

The aim of this study was to evaluate predictive value of main arterial markers for cardiovascular (CV) events in subjects with metabolic syndrome (MetS).

Methods

A prospective study enrolled 2728 middle-aged (53.9 ± 6.2 years old, 63% women) MetS patients of the Lithuanian High Cardiovascular Risk primary prevention program without overt CV disease. Subjects were followed-up for 3.9 ±1.7 years for fatal or non-fatal myocardial infarction (MI) or stroke after their initial assessment including evaluation of carotid intima-media thickness (cIMT), aortic augmentation index (AIx), aortic pulse wave velocity (aPWV), brachial flow-mediated dilatation (FMD), carotid stiffness index, and cardio-ankle vascular index (CAVI).

Results

83 (3%) patients had at least one cardiovascular event during the follow-up period. Univariate analysis showed association of CV events with higher mean blood pressure, aPWV, AIx, cIMT, and lower FMD (all p < 0.05). Cox proportional hazard regression analysis revealed association between CV events, increase in cIMT (HR 1.31, 95% CI 1.14–1.50, p < 0.001), aPWV (HR 1.29, 95% CI 1.04–1.60, p = 0.019), AIx (HR 1.53, 95% CI 1.16–2.02, p = 0.003) and decrease in FMD (HR 0.83, 95% CI 0.71–0.97, p = 0.016) even after the adjustment for age, gender, and common CV risk factors. Using two-level survival trees analysis, we discovered relation between cIMT > 794 and higher CV risk (p < 0.001) and even higher risk with aPWV > 11.1 m/s (p = 0.023). Whereas cIMT£794 mcm together with the FMD cut-off point of 6.5% also resulted in higher risk (p = 0.003).

Conclusions

Our follow-up study reveals association between CV risk, increased aortic PWV, cIMT and decreased brachial FMD among middle-aged MetS patients.