P24 SEX-SPECIFIC PULSE WAVE VELOCITY CUT-OFFS IMPROVE SURVIVAL ANALYSIS IN PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE

DOI

10.1016/j.artres.2017.10.165How to use a DOI?

Abstract

Objectives: There is evidence for sex and age influences on pulse wave velocity (PWV). Guidelines suggest a sex-independent cut-off for PWV. It is not obvious that an age- and blood-pressure-independent cut-off is suitable in different populations [1, 2].

Thus, the aim is to investigate the suitability of sex-independent cut-offs for risk prediction in a high-risk cohort.

Methods: PWV was measured invasively (invPWV; catheter pullback) and non-invasively (non- invPWV; ARCSolver PWV) for patients with suspected CAD at the hospital in Wels- Grieskirchen (Austria). Patients were grouped in four subgroups based on sex and PWV cut-offs (guidelines and sex-specific ones). A combination of myocardial infarction, death, stroke and cardiovascular revascularization served as primary endpoint. Kaplan-Meier curves, logrank test and hazard-ratios were used for survival analysis and receiver-operating-characteristics (ROC) to determine sex-specific cut- offs.

Results: 604 male (61 (11 SD) years) and 324 female (65 (11 SD) years) with a median follow-up of 1576 days and 215 events were included. Logrank test revealed significant differences between Kaplan-Meier curves (p < 0.001), but dichotomized PWV remained just discriminative in women, but not men, for invasive and non- invasive recordings. ROC analysis revealed sex-specific cut-offs of 8.5 m/s (men) or 9.6 m/s (women) for invasive and 8.9 m/s (men) or 10.0 m/s (women) for non- invasive recordings. When using these cut-offs, PWV turned out to be discriminative in both sexes (Table).

	HR (≤10m/s vs. >10m/s)	Sex-specific cut-off	HR (≤ sex-specific cut-off vs. > sex-specific cut-off)
invPWV
Male	1.41 [0.94; 2.11]	8.5 m/s	1.64 [1.15; 2.34]
Female	2.46 [1.58; 3.84]	9.6 m/s	3.28 [2.14; 5.03]
non-invPWV
Male	1.46 [0.99; 2.16]	8.9 m/s	1.73 [1.22; 2.46]
Female	3.20 [2.11; 4.85]	10.0 m/s	3.20 [2.11; 4.85]

Table.

Results of survival and ROC analysis for invasive and non-invasive PWV for male and female. Hazard-ratios (HR) are presented with their 95% confidence intervals.

Conclusion: Sex-specific PWV cut-offs improve survival analysis in patients with suspected CAD. Cut-offs seem to be directly dependent on the prevalence of CAD and thus need further investigation.

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TY  - JOUR
AU  - Christopher C. Mayer
AU  - Bernhard Hametner
AU  - Katy Whitelegg
AU  - Thomas Weber
AU  - Siegfried Wassertheurer
PY  - 2017
DA  - 2017/12/06
TI  - P24 SEX-SPECIFIC PULSE WAVE VELOCITY CUT-OFFS IMPROVE SURVIVAL ANALYSIS IN PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE
JO  - Artery Research
SP  - 100
EP  - 100
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.165
DO  - 10.1016/j.artres.2017.10.165
ID  - Mayer2017
ER  -