3.7 Pulse Wave Velocity is an Independent Risk Factor for Cardiovascular Events, Mortality and Decline in Renal Function in Patients with Type 1 Diabetes

Purpose The prognostic significance of carotid-femoral pulse wave velocity (cfPWV) remains to be determined in patients with type 1 diabetes (T1D). We investigated the predictive value of cfPWV for various endpoints in T1D. Methods At baseline, cfPWV was measured using the SphygmoCor device in 652 p...

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Veröffentlicht in:Artery research Jg. 24; H. 1; S. 74
Hauptverfasser: Hansen, Tine Willum, Frimodt-Møller, Marie, Theilade, Simone, Tofte, Nete, Ahluwalia, Tarun Veer Singh, Rossing, Peter
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Dordrecht Springer Netherlands 01.12.2018
Springer Nature B.V
BMC
Schlagworte:
ARTERY 18
Diabetes
Guimaraes Oral Presentation abstracts
Mortality
ISSN:1872-9312, 1876-4401, 1876-4401
Online-Zugang:Volltext
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Zusammenfassung:Purpose The prognostic significance of carotid-femoral pulse wave velocity (cfPWV) remains to be determined in patients with type 1 diabetes (T1D). We investigated the predictive value of cfPWV for various endpoints in T1D. Methods At baseline, cfPWV was measured using the SphygmoCor device in 652 patients with T1D and various degrees of albuminuria. Endpoints were traced through National Registers and patient records and comprised: composite CVE, mortality, progression in albuminuria, and decline in estimated glomerular filtration rate (eGFR) >30%. Median follow-up ranged from 5.2 to 6.2 years. Slope estimates of eGFR and urinary albumin creatinine rate (UACR) were calculated for a median of 5.5 years. Adjustment included sex, age, mean arterial pressure, LDL cholesterol, smoking, HbA1c, UACR and eGFR at baseline. Hazard ratios (HR) were calculated per 1 standard derivation (SD) increase in cfPWV. Results Of the 652 participants (56% male); mean±SD age was 54 ± 13 years and cfPWV 10.5 ± 3.38 m/s 2 . After adjustment, higher cfPWV was significantly associated with all endpoints: composite CVE (n = 81; HR:1.31; p = 0.045); mortality (n = 48; HR:1.39; p = 0.033); progression in albuminuria (n = 31; HR:1.16; p = 0.012); and decline in eGFR > 30% (n = 90; HR: 1.39; p = 0.015).Higher cfPWV was associated with a steeper decline in eGFR and a steeper increase in UACR after adjustments (p < 0.009). Conclusions In patients with T1D, higher arterial stiffness was consistently associated with a higher risk of CVE, mortality and decline in renal function, independent of other risk factors. Measurement of cfPWV may have a promising role in risk stratification in T1D.
Bibliographie:ObjectType-Article-1
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content type line 14
ISSN:1872-9312
1876-4401
1876-4401
DOI:10.1016/j.artres.2018.10.038