Related Experiment Video
Updated: Oct 25, 2025
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Improved Prognostic Value in Predicting Long-Term Cardiovascular Events by a Combination of High-Sensitivity
Hack-Lyoung Kim1, Woo-Hyun Lim1, Jae-Bin Seo1
1Boramae Medical Center, Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, 5 Boramae-ro, Dongjak-gu, Seoul 07061, Korea.
Insights
Combining high-sensitivity C-reactive protein (hs-CRP) and brachial-ankle pulse wave velocity (baPWV) measurements improves cardiovascular risk prediction. This combined approach offers better stratification for major adverse cardiovascular events (MACE) than individual measures alone.
Area of Science:
- Cardiology
- Biomarkers
- Vascular Health
Background:
- C-reactive protein (CRP) and arterial stiffness are established risk factors for cardiovascular disease (CVD).
- Current risk stratification models may not fully capture individual patient risk.
- Investigating combined biomarkers can enhance CVD risk assessment.
Purpose of the Study:
- To evaluate if combining high-sensitivity CRP (hs-CRP) and brachial-ankle pulse wave velocity (baPWV) improves cardiovascular risk stratification.
- To assess the prognostic value of hs-CRP and baPWV, individually and in combination, for major adverse cardiovascular events (MACE).
Main Methods:
- Retrospective analysis of 6572 subjects with hs-CRP and baPWV measurements.
- Assessment of major adverse cardiovascular events (MACE) including cardiovascular death, myocardial infarction, revascularization, and stroke.
- Statistical analysis to determine hazard ratios and prognostic value of combined markers.
Main Results:
- Elevated baPWV (≥1505 cm/s) and hs-CRP (≥3 mg/L) were independently associated with increased MACE risk.
- The combination of high baPWV and high hs-CRP significantly increased MACE risk (HR, 7.08).
- Adding baPWV to clinical factors and hs-CRP improved prognostic value (global Chi-square from 126 to 167).
Conclusions:
- The combined assessment of hs-CRP and baPWV offers superior prediction of future CVD events compared to individual measurements.
- Simultaneous measurement of hs-CRP and baPWV is a clinically valuable tool for enhancing cardiovascular risk stratification.
- This combined approach aids in identifying high-risk individuals for targeted interventions.
Background:
Both C-reactive protein (CRP) and arterial stiffness are associated with the development of cardiovascular disease (CVD). This study was performed to investigate whether a combination of these two measurements could improve cardiovascular risk stratification.
Methods:
A total of 6572 consecutive subjects (mean age, 60.8 ± 11.8 years; female, 44.2%) who underwent both high-sensitivity CRP (hs-CRP) and brachial-ankle pulse wave velocity (baPWV) measurement within 1 week were retrospectively analyzed. Major adverse cardiovascular events (MACE), including cardiovascular death, acute myocardial infarction, coronary revascularization, and stroke were assessed during the clinical follow-up.
Results:
During a mean follow-up period of 3.75 years (interquartile range, 1.78-5.31 years), there were 182 cases of MACE (2.8%). The elevated baPWV (≥1505 cm/s) (hazard ratio (HR), 4.21; 95% confidence interval (CI), 2.73-6.48; p < 0.001) and hs-CRP (≥3 mg/L) (HR, 1.57; 95% CI, 1.12-2.21; p < 0.001) levels were associated with MACE even after controlling for potential confounders. The combination of baPWV and hs-CRP further stratified the subjects' risk (subjects with low baPWV and hs-CRP vs. subjects with high baPWV and hs-CRP; HR, 7.08; 95% CI, 3.76-13.30; p < 0.001). Adding baPWV information to clinical factors and hs-CRP had an incremental prognostic value (global Chi-square score, from 126 to 167, p < 0.001).
Conclusions:
The combination of hs-CRP and baPWV provided a better prediction of future CVD than either one by itself. Taking these two simple measurements simultaneously is clinically useful in cardiovascular risk stratification.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:23Assessment of blood pressure in brachial artery(two-step method)
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT