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 65...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-12-01
|
| Series: | Artery Research |
| Online Access: | https://www.atlantis-press.com/article/125929986/view |
| _version_ | 1818006116050665472 |
|---|---|
| author | Tine Willum Hansen Marie Frimodt-Møller Simone Theilade Nete Tofte Tarun Veer Singh Ahluwalia Peter Rossing |
| author_facet | Tine Willum Hansen Marie Frimodt-Møller Simone Theilade Nete Tofte Tarun Veer Singh Ahluwalia Peter Rossing |
| author_sort | Tine Willum Hansen |
| collection | DOAJ |
| description | 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/s2. 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. |
| first_indexed | 2024-04-14T04:55:47Z |
| format | Article |
| id | doaj.art-761394ff649241d384b8a38de3d37b19 |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-04-14T04:55:47Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-761394ff649241d384b8a38de3d37b192022-12-22T02:11:08ZengBMCArtery Research1876-44012018-12-012410.1016/j.artres.2018.10.0383.7 PULSE WAVE VELOCITY IS AN INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR EVENTS, MORTALITY AND DECLINE IN RENAL FUNCTION IN PATIENTS WITH TYPE 1 DIABETESTine Willum HansenMarie Frimodt-MøllerSimone TheiladeNete TofteTarun Veer Singh AhluwaliaPeter RossingPurpose: 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/s2. 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.https://www.atlantis-press.com/article/125929986/view |
| spellingShingle | Tine Willum Hansen Marie Frimodt-Møller Simone Theilade Nete Tofte Tarun Veer Singh Ahluwalia Peter Rossing 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 Artery Research |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://www.atlantis-press.com/article/125929986/view |
| work_keys_str_mv | AT tinewillumhansen 37pulsewavevelocityisanindependentriskfactorforcardiovasculareventsmortalityanddeclineinrenalfunctioninpatientswithtype1diabetes AT mariefrimodtmøller 37pulsewavevelocityisanindependentriskfactorforcardiovasculareventsmortalityanddeclineinrenalfunctioninpatientswithtype1diabetes AT simonetheilade 37pulsewavevelocityisanindependentriskfactorforcardiovasculareventsmortalityanddeclineinrenalfunctioninpatientswithtype1diabetes AT netetofte 37pulsewavevelocityisanindependentriskfactorforcardiovasculareventsmortalityanddeclineinrenalfunctioninpatientswithtype1diabetes AT tarunveersinghahluwalia 37pulsewavevelocityisanindependentriskfactorforcardiovasculareventsmortalityanddeclineinrenalfunctioninpatientswithtype1diabetes AT peterrossing 37pulsewavevelocityisanindependentriskfactorforcardiovasculareventsmortalityanddeclineinrenalfunctioninpatientswithtype1diabetes |