3.4 A CLINICAL SCORE TO PREDICT ELEVATED ARTERIAL STIFFNESS: DERIVATION AND VALIDATION IN 3,943 HYPERTENSIVE PATIENTS

Panagiotis Xaplanteris; Charalambos Vlachopoulos; Athanasios Protogerou; Konstantinos Aznaouridis; Dimitris Terentes-Printzios; Antonis Argyris; Nikolaos Tentolouris; Petros Sfikakis; Dimitris Tousoulis

doi:10.1016/j.artres.2018.10.035

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Volume 24, Issue C, December 2018, Pages 73 - 73

3.4 A CLINICAL SCORE TO PREDICT ELEVATED ARTERIAL STIFFNESS: DERIVATION AND VALIDATION IN 3,943 HYPERTENSIVE PATIENTS

Authors

Panagiotis Xaplanteris¹, Charalambos Vlachopoulos², Athanasios Protogerou³, Konstantinos Aznaouridis², Dimitris Terentes-Printzios², Antonis Argyris³, Nikolaos Tentolouris³, Petros Sfikakis³, Dimitris Tousoulis²

¹CHU Saint Pierre, Brussels, Belgium

²Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece

³Laiko University General Hospital, Cardiovascular Prevention and Research Unit, Department of Pathophysiology, Athens, Greece

Available Online 4 December 2018.

DOI: 10.1016/j.artres.2018.10.035 How to use a DOI?
Abstract: Purpose/Background/Objectives: Aortic stiffness assessed by carotid-femoral pulse wave velocity (PWV) is an important predictor to gauge the overall risk of hypertensive patients; nonetheless, it is underutilized in everyday practice. We derived a simple scoring system based on clinical variables that can identify patients with a priority for measurement of PWV, i.e. those with elevated PWV (≥ 10 m/sec) and at higher risk for events.

Methods: Patient data from three outpatient clinics (n = 3,943) were used to form a derivation, internal and external validation cohort. For derivation, independent predictors of high PWV from a binary logistic regression model were dichotomized and implemented in a clinical prediction scoring system with the acronym SAGE (office systolic blood pressure ≥160 mmHg: 4 points, age ≥ 60 years: 4 points, glycemia [blood glucose ≥126 mg/dl]: 1 point, eGFR ≤60: 2 points).

Results: Its performance was validated at the internal and external validation cohorts with c-statistics being 0.781 (95% CI: 0.753–0.808) and 0.718 (95% CI: 0.682–0.755) respectively (Figure 1). A cut-off of 5 points to identify patients with high PWV in the external validation cohort yielded a positive predictive value, negative predictive value, sensitivity and specificity of 60.7%, 84.8%, 51.9% and 78.3% respectively.

Conclusions: The SAGE score that takes into account easily measured clinical variables (systolic blood pressure, age, glucose and eGFR) can be used to predict elevated levels of PWV and prioritize its measurement in specific patients. Its use will result in greater acknowledgement of the role of aortic stiffness and aid physicians in implementing it in clinical practice.
Open Access: This is an open access article distributed under the CC BY-NC license.

References

1.C Vlachopoulos, K Aznaouridis, and C Stefanadis, Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis, J Am Coll Cardiol, Vol. 55, No. 13, 2010, pp. 1318-1327.

2.Y Ben-Shlomo, M Spears, C Boustred, M May, SG Anderson, EJ Benjamin, et al., Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects, J Am Coll Cardiol, Vol. 63, No. 7, 2014, pp. 636-646.

3.C Vlachopoulos, P Xaplanteris, V Aboyans, M Brodmann, R Cifkova, F Cosentino, et al., The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society, Atherosclerosis, Vol. 241, No. 2, 2015, pp. 507-532.

4.Reference Values for Arterial Stiffness C. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’, Eur Heart J, Vol. 31, No. 19, 2010, pp. 2338-2350.

5.CM McEniery, M Spratt, M Munnery, J Yarnell, GD Lowe, A Rumley, et al., An analysis of prospective risk factors for aortic stiffness in men: 20-year follow-up from the Caerphilly prospective study, Hypertension, Vol. 56, No. 1, 2010, pp. 36-43.

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Journal: Artery Research
Volume-Issue: 24 - C
Pages: 73 - 73
Publication Date: 2018/12/04
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2018.10.035 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - Panagiotis Xaplanteris
AU  - Charalambos Vlachopoulos
AU  - Athanasios Protogerou
AU  - Konstantinos Aznaouridis
AU  - Dimitris Terentes-Printzios
AU  - Antonis Argyris
AU  - Nikolaos Tentolouris
AU  - Petros Sfikakis
AU  - Dimitris Tousoulis
PY  - 2018
DA  - 2018/12/04
TI  - 3.4 A CLINICAL SCORE TO PREDICT ELEVATED ARTERIAL STIFFNESS: DERIVATION AND VALIDATION IN 3,943 HYPERTENSIVE PATIENTS
JO  - Artery Research
SP  - 73
EP  - 73
VL  - 24
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2018.10.035
DO  - 10.1016/j.artres.2018.10.035
ID  - Xaplanteris2018
ER  -

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