Microvascular function predicts cardiovascular events in primary prevention: long-term results from the Firefighters...

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Biomarkers

Background:

• Atherosclerosis biomarkers can refine clinical decisions for individuals at risk of cardiovascular disease.
• Assessing endothelial function and vascular markers aids in risk stratification for apparently healthy men.

Purpose of the Study:

• To determine the prognostic significance of endothelial function and other vascular markers in apparently healthy men.
• To evaluate if microvascular function markers improve cardiovascular risk prediction.

Main Methods:

• 1574 apparently healthy men were studied, measuring flow-mediated dilation, hyperemic velocity, carotid intima-media thickness, and C-reactive protein.
• Cox proportional hazard models assessed relationships between vascular markers, Framingham risk score, and cardiovascular events.
• Follow-up averaged 7.2 years for a composite cardiovascular endpoint.

Main Results:

• Hyperemic velocity (HR, 0.70) and carotid intima-media thickness (HR, 1.45) were significant predictors of cardiovascular events.
• Flow-mediated dilation and C-reactive protein were not associated with events.
• Adding hyperemic velocity to the Framingham risk score significantly improved risk reclassification in intermediate-risk men.

Conclusions:

• Hyperemic velocity, a marker of microvascular function, is a significant predictor of adverse cardiovascular outcomes in men.
• This marker's prognostic value is additive to traditional risk factors and carotid intima-media thickness.
• Hyperemic velocity offers a novel tool for improving cardiovascular risk stratification in lower-risk healthy men.