Cardiovascular endpoints in relation to the central arterial pressure-time indexes

Area of Science:

• Cardiovascular Physiology
• Biomedical Engineering
• Epidemiology

Background:

• Central arterial pressure-time indexes, such as systolic (SPTI) and diastolic (DPTI) pressure-time indexes, and the subendocardial viability ratio (SEVR) are established measures.
• Their utility in risk stratification within the general population remains largely uncharacterized.

Purpose of the Study:

• To investigate the predictive value of noninvasively measured SPTI, DPTI, and SEVR for cardiovascular outcomes and stroke in a general population.
• To assess the incremental predictive value of these indexes in cardiovascular risk stratification models.

Main Methods:

• Utilized data from the International Database of Central Arterial Properties for Risk Stratification (n=5099).
• Noninvasively measured SPTI, DPTI, and SEVR using SphygmoCor technology.
• Evaluated hazard ratios (HRs) for cardiovascular endpoints, cardiac endpoints, and stroke using multivariable-adjusted Cox proportional hazards models over a median follow-up of 4 years. Model refinement was assessed using AUC, IDI, and NRI.

Main Results:

• SPTI and DPTI were significantly associated with increased risk of cardiovascular endpoints, cardiac endpoints, and stroke (HRs ranging from 1.33 to 1.74).
• SEVR did not show a significant association with any of the evaluated endpoints.
• Adding SPTI or DPTI to risk models improved discrimination, with combined use with mean arterial pressure significantly increasing IDI (~1.7%) and NRI (~17%).

Conclusions:

• Noninvasively measured SPTI and DPTI are valuable independent predictors of cardiovascular events and stroke in the general population.
• SEVR does not appear to contribute to cardiovascular risk stratification in this population.
• These findings support the integration of SPTI and DPTI into cardiovascular risk assessment tools.