Aortic pulse wave velocity and HeartSCORE: Improving cardiovascular risk stratification. A sub-analysis of the EDIVA (Estudo de DIstensibilidade VAscular) project

Figures & data

Table I. Baseline characteristics of the study cohort.

	Total (n = 1709)	Subjects without event (n = 1662)	Subjects with event (n = 47)	p
Age, years, mean (± SD)	51.68 (± 10.49)	51.65 (± 10.51)	58.89 (± 9.43)	0.434
Gender, men:women (%)	56:44	56:43	53:46	0.179
Body mass index, kg/m^2, mean (± SD)	27.61 (± 4.40)	27.58 (± 4.34)	28.70 (± 12.90)	0.092
Smoking, n (%)	257 (14)	235 (14.1)	10 (21.2)	0.126
Hypertension, n (%)	1003 (58.6)	965 (58)	38 (80.8)	< 0.001
Dyslipidemia, n (%)	605 (35.4)	585 (35.1)	20 (44.4)	0.197
Diabetes, n (%)	199 (11.6)	192 (11.5)	7 (14.8)	0.407
SBP, mmHg, median (IQR)	140 (30)	140 (30)	160 (22)	< 0.001
DBP, mmHg, median (IQR)	85 (15)	85 (15)	91 (13)	< 0.001
PP, mmHg, median (IQR)	56 (19)	56 (19)	66 (13)	0.004
MAP, mmHg, median (IQR)	105 (18)	104 (15)	120 (15)	< 0.001
Heart rate, beats/min, mean (± SD)	70.85 (± 11.67)	70.66 (± 11.85)	77.60 (± 12.90)	< 0.001
PWV, m/s, mean (± SD)	10.44 (± 2.03)	10.40 (± 2.01)	11.82 (± 2.16)	< 0.001
Plasma total cholesterol, mg/dl, median (IQR)	189 (70)	190 (69)	178 (97)	0.311
Plasma glucose, mg/dl, median (IQR)	91 (19)	91 (21)	94 (30)	0.812
Plasma creatinine, mg/dl, median (IQR)	0.82 (0.4)	0.83 (0.4)	0.80 (0.4)	0.557
Plasma triglycerides, mg/dl, median (IQR)	114 (42)	114 (41)	106 (41)	0.872

PWV, pulse wave velocity; SBP, systolic blood pressure; DBP, diastolic blood pressure; PP, pulse pressure; MAP, mean arterial pressure; SD, standard deviation; IQR, interquartile range.

Table II. Multiple-adjusted hazard ratios and 95% confidence intervals (CI) for cardiovascular risk factors increasing risk of major adverse cardiovascular events.

Parameter	Hazard ratio	95% CI	p
Gender (female)	2.74	1.41–5.32	0.003
Age (per 1-year increment)	1.03	1.01–1.05	0.001
Total cholesterol (per 1 mg/dl)	0.99	0.99–1.01	0.390
SBP (per 10 mmHg)	1.03	1.02–1.04	< 0.001
Diabetes (yes)	1.15	0.50–2.67	0.741
Smoking status (yes)	1.02	0.50–2.01	0.821
PWV (per 1 − SD, m/s)	1.86	1.37–2.53	< 0.001

PWV, pulse wave velocity; SBP, systolic blood pressure.

Table III. Measures of model fit, discrimination, and calibration for major adverse cardiovascular events adding carotid–femoral pulse wave velocity.

	Model fit			Discrimination C statistic (95% CI)	Calibration
Model	− 2 log likelihood	Akaike information criteria	Schwartz's Bayesian information criterion		χ^2	p
Age, sex	666.22	670.23	681.62	0.69 (0.61–0.80)	10.92	0.21
Add PWV	634.42	640.42	657.51	0.78 (0.64–0.83)^a	5.68	0.68
Age, sex, total cholesterol, systolic blood pressure, smoking, diabetes mellitus, hypertension treatment	624.69	636.69	670.86	0.82 (0.66–0.85)	11.85	0.17
Add PWV	608.03	622.15	662.02	0.86 (0.74–0.90)^b	5.17	0.74

For a description of the tests displayed in the table, please refer to Methods, Statistical analysis.

^aComparison of C statistics in rows 1 and 2, P ≤ 0.005.

^bComparison of C statistics in rows 3 and 4, p ≤ 0.03.

Figure 1. Cox regression coefficients of cumulative probability of a first major adverse cardiovascular event when participants were grouped according to tertiles of carotid–femoral pulse wave velocity and three SCORE risk classes.

Figure 2. Kaplan–Meier plot of cumulative probability of major adverse cardiovascular events when participants were grouped according to SCORE categories (low- and intermediate-risk category – SCORE < 5%; high-risk category – SCORE > 5%) and stratified to tertiles of PWV (solid line – highest tertile; dashed lines – intermediate and lowest tertiles).