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Pulse Wave Velocity can detect High Cardiovascular Risk in asymptomatic patients with Metabolic Syndrome
Session:
Posters - J. Preventive Cardiology
Speaker:
Margarida Temtem
Congress:
CPC 2021
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.2 Risk Factors and Prevention – Cardiovascular Risk Assessment
Session Type:
Posters
FP Number:
---
Authors:
Margarida Temtem; Marco Gomes Serrão; Isabel Mendonça; Marina Santos; Flávio Mendonça; Adriano Sousa; Ana Célia Sousa; Mariana Rodrigues; Sónia Freitas; Eva Henriques; Sofia Borges; Graça Guerra; António Drumond; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Background: </strong>Metabolic syndrome (MetS) is a clinical condition composed of metabolic and cardiovascular risk factors, such as abdominal obesity, hyperglycemia, dyslipidemia and hypertension. Many<span style="color:black"><span style="background-color:white"> patients with MetS suffer major adverse cardiovascular events (MACE) that are not adequately identified by traditional risk assessment, suggesting the need for early detection of subclinical coronary heart disease to identify those at higher risk. Carotid-femoral pulse wave velocity (PWV), a direct measure of aortic stiffness, has become increasingly crucial for cardiovascular (CV) risk estimation, particularly in patients with high CV risk, as those with MetS.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Purpose: </strong>Evaluate the PWV <span style="color:black"><span style="background-color:white">assessment in an asymptomatic population and estimate its prognostic impact in </span></span>CV events risk prediction, in<span style="color:black"><span style="background-color:white"> patients with metabolic syndrome</span></span>.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods:</strong> The study was performed with 1122 asymptomatic individuals (507 with MetS and 615 controls) without known coronary heart disease, enrolled from GENEMACOR study. This population was followed-up for a mean of 5.3±3.4 years for the primary endpoint of all cardiovascular events. PWV was measured by tonometry, through an automatic device, the Complior and two groups were established, one with PWV ≤10 m/s and another with PWV >10 m/s. Individuals with MetS and controls were compared in terms of PWV values, and the association of PWV with events occurrence was evaluated. Finally, a logistic regression model adjusted for PWV was performed in patients with MetS. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results:</strong> Patients with Mets (16.3%, n=81) had higher PWV values in comparison to controls (8.61±1.83 vs 7.73±1.54 m/s p<0.0001). In this cohort of MetS patients with PWV > 10m/s, 46.7% vs 15.4% had MACE (p=0.005) during the follow-up. The logistic regression analysis has revealed that PWV>10m/s is a MACE predictor (OR=4.812, CI 95% 1.694-13.673, p=0.003) in patients with MetS.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion:</strong> Our results evidence that patients with MetS had higher PWV levels and a higher probability of MACE than those with lower PWV. These results reveal the predictive role of this simple assessment in cardiovascular risk estimation.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">The particular fact that these patients with MetS have a significant CV risk, <span style="color:black"><span style="background-color:white">despite tight control of risk factors, </span></span>PWV is a useful tool to identify patients that must intensify the preventive and therapeutic approach.</span></span></span></p>
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