Radial augmentation index is a surrogate marker of atherosclerotic burden in a primary prevention cohort
David Rosenbaum1, Philippe Giral, John Chapman
1Unité de Prévention Cardiovasculaire, Service d'Endocrinologie-Métabolisme, Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France; Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), Paris, France.
Insights
Arterial stiffness, measured by augmentation index, is linked to subclinical atherosclerosis in asymptomatic individuals. This marker independently predicts cardiovascular risk factors and plaque presence.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Preventive Cardiology
Background:
- Arterial stiffness is a key cardiovascular risk factor, predicting clinical events independently of blood pressure.
- The association between radial augmentation index and subclinical atherosclerosis in asymptomatic populations requires further clarification.
Purpose of the Study:
- To investigate the relationship between the peripheral augmentation index and traditional cardiovascular risk factors.
- To assess the presence of subclinical atherosclerosis in a large, asymptomatic primary prevention cohort.
Main Methods:
- Radial augmentation index was measured in 1007 primary prevention patients with at least one cardiovascular risk factor.
- Common carotid intima-media thickness, plaque presence, and Framingham 10-year cardiovascular risk score were assessed.
- Multivariate analysis was employed to determine independent relationships.
Main Results:
- The mean augmentation index was 81 ± 13%, differing significantly between men and women.
- Augmentation index positively correlated with cardiovascular risk, age, blood pressure, and intima-media thickness.
- Independent associations were found between augmentation index and intima-media thickness, and augmentation index and plaque presence.
Conclusions:
- The augmentation index is significantly related to subclinical atherosclerosis in a large primary prevention population.
- This study confirms the augmentation index as a valuable surrogate marker for arterial stiffness and atherosclerosis.
- Findings support the use of augmentation index in assessing cardiovascular risk in asymptomatic individuals.
Abstract:
Arterial stiffness is linked to cardiovascular risk and predicts clinical events independently of peripheral blood pressure. The potential relationship between the augmentation index measured at the radial artery and asymptomatic atherosclerosis remains unclear however. In order to assess relationship between the peripheral augmentation index and traditional risk factors, we estimated cardiovascular risk and presence of subclinical atherosclerosis in a large asymptomatic population in primary prevention. Patients in primary prevention (n = 1007) with at least 1 cardiovascular risk factor were included and radial augmentation index was measured. Maximum common carotid intima-media thickness, the presence of plaque and Framingham 10 year cardiovascular risk score were assessed. The mean augmentation index was 81 ± 13% in a population composed of 55% males (mean age 56 years). The augmentation index differed significantly between men (77 ± 12%) and women (86 ± 12%). In the global population, augmentation index was negatively correlated to height and weight, and positively correlated to cardiovascular risk, age, systolic blood pressure, pulse pressure, diabetes, HDL-Cholesterol, fasting glucose, intima-media thickness and to the presence of plaques. Multivariate analysis in the global and in the male population revealed an independent and positive relationship between augmentation index and intima-media thickness on the one hand, and between augmentation index and the presence of plaque on the other. Our results confirm that there are significant relationships between a surrogate marker of arterial stiffness and subclinical atherosclerosis in a large primary prevention population.
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