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Umbral Basado en Puntos Finales para el Índice Ambulatorio de Rigidez Arterial

Yi-Bang Cheng¹, De-Wei An¹, Dong-Yan Zhang^1,2,3

¹Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, National Research Centre for Translational Medicine, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China. (Y.-B.C, D.-W.A., D.-Y.Z., Q.-F.H., J.G.W., Y.L., J.A.S).

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Resumen

El índice ambulatorio de rigidez arterial (AASI) predice eficazmente los eventos cardiovasculares y la mortalidad por todas las causas. Un umbral de AASI de 0,50 indica un mayor riesgo, lo que requiere un manejo más estrecho de los factores de riesgo cardiovascular.

Palabras clave:

presión arterial enfermedades cardiovasculares morbilidad mortalidad rigidez vascular

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Área de la Ciencia:

Cardiología
Medicina Preventiva
Bioestadística

Sus antecedentes:

El índice ambulatorio de rigidez arterial (AASI) se utiliza cada vez más en la investigación clínica y la práctica para la evaluación del riesgo cardiovascular.
La rigidez arterial es un predictor significativo de eventos cardiovasculares y mortalidad.

Objetivo del estudio:

Consolidar la precisión pronóstica del AASI en la población general.
Derivar un umbral de riesgo de AASI basado en puntos finales para mejorar la estratificación del riesgo cardiovascular.

Principales métodos:

Un metaanálisis de participantes individuales de 14 estudios poblacionales que involucraron a 12.558 individuos.
AASI derivado por regresión de la presión arterial diastólica de 24 horas sobre la presión arterial sistólica.
Se utilizó la regresión de Cox para establecer umbrales de riesgo.
El análisis incluyó niveles crecientes de AASI paso a paso y la determinación de AASI que produce un riesgo a 10 años equivalente a una presión sistólica de oficina de 140 mmHg.

Principales resultados:

A lo largo de un período mediano de 10,7 años, ocurrieron 3027 muertes y 2183 eventos cardiovasculares.
Cada incremento de 1-DE en AASI se asoció con un mayor riesgo de muerte por todas las causas (HR 1,08) y eventos cardiovasculares (HR 1,13).
Se identificó un umbral de AASI que transporta riesgo de 0,50, asociado con riesgos significativamente mayores para ambos resultados, mejorando el rendimiento del modelo.

Conclusiones:

El AASI mejora significativamente la estratificación del riesgo cardiovascular más allá de los factores de riesgo tradicionales.
Superar el umbral de AASI de 0,50 justifica una mayor vigilancia en el manejo de los factores de riesgo para prevenir complicaciones cardiovasculares.