Author + information
- Received July 13, 2009
- Revision received September 28, 2009
- Accepted October 12, 2009
- Published online March 30, 2010.
- Charalambos Vlachopoulos, MD⁎ (, )
- Konstantinos Aznaouridis, MD and
- Christodoulos Stefanadis, MD
- ↵⁎Reprint requests and correspondence:
Dr. Charalambos Vlachopoulos, 1st Department of Cardiology, Athens Medical School, Profiti Elia 24, Athens 14575, Greece
Objectives The purpose of this study was to calculate robust quantitative estimates of the predictive value of aortic pulse wave velocity (PWV) for future cardiovascular (CV) events and all-cause mortality by meta-analyses of longitudinal studies.
Background Arterial stiffness is increasingly recognized as a surrogate end point for CV disease.
Methods We performed a meta-analysis of 17 longitudinal studies that evaluated aortic PWV and followed up 15,877 subjects for a mean of 7.7 years.
Results The pooled relative risk (RR) of clinical events increased in a stepwise, linear-like fashion from the first to the third tertile of aortic PWV. The pooled RRs of total CV events, CV mortality, and all-cause mortality were 2.26 (95% confidence interval: 1.89 to 2.70, 14 studies), 2.02 (95% confidence interval: 1.68 to 2.42, 10 studies), and 1.90 (95% confidence interval: 1.61 to 2.24, 11 studies), respectively, for high versus low aortic PWV subjects. For total CV events and CV mortality, the RR was significantly higher in high baseline risk groups (coronary artery disease, renal disease, hypertension) compared with low-risk subjects (general population). An increase in aortic PWV by 1 m/s corresponded to an age-, sex-, and risk factor–adjusted risk increase of 14%, 15%, and 15% in total CV events, CV mortality, and all-cause mortality, respectively. An increase in aortic PWV by 1 SD was associated with respective increases of 47%, 47%, and 42%.
Conclusions Aortic stiffness expressed as aortic PWV is a strong predictor of future CV events and all-cause mortality. The predictive ability of arterial stiffness is higher in subjects with a higher baseline CV risk.
Drs. Vlachopoulos and Aznaouridis contributed equally to this study.
- Received July 13, 2009.
- Revision received September 28, 2009.
- Accepted October 12, 2009.
- American College of Cardiology Foundation