The Prognostic Value of Arterial Stiffness According to Socioeconomic Status
Background: Individuals of low socioeconomic status (SES) often exhibit increased cardiovascular risk factors and a worse prognosis. We conducted this study to ascertain whether brachial-ankle pulse wave velocity (baPWV), a straightforward and reliable measure of arterial stiffness, can hold prognos...
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| Format: | Article |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/21/6943 |
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| author | Woo-Hyun Lim Hack-Lyoung Kim Hyun Sung Joh Jae-Bin Seo Sang-Hyun Kim Joo-Hee Zo Myung-A Kim |
| author_facet | Woo-Hyun Lim Hack-Lyoung Kim Hyun Sung Joh Jae-Bin Seo Sang-Hyun Kim Joo-Hee Zo Myung-A Kim |
| author_sort | Woo-Hyun Lim |
| collection | DOAJ |
| description | Background: Individuals of low socioeconomic status (SES) often exhibit increased cardiovascular risk factors and a worse prognosis. We conducted this study to ascertain whether brachial-ankle pulse wave velocity (baPWV), a straightforward and reliable measure of arterial stiffness, can hold prognostic value for people with low SES. Methods: We retrospectively analyzed a total of 1266 subjects (mean age 64.6 ± 11.6 years; 47.2% female) without documented cardiovascular disease who had undergone baPWV measurement. The subjects included 633 National Health Insurance Beneficiaries (NHIB) and 633 Medical Aid Beneficiaries (MAB), matched for major clinical features through a 1:1 propensity score matching method. Major adverse cardiovascular events (MACE), such as death, non-fatal myocardial infarction, non-fatal ischemic stroke, coronary revascularization, and heart failure necessitating admission, were assessed during the clinical follow-up. Results: During a median follow-up period of 4.2 years (interquartile range, 2.2–5.7 years), there were 77 MACE cases (6.1%). In multivariable Cox regression analyses, baPWV was identified as a significant predictor of MACE in both groups, regardless of the use of three different baPWV criteria (median value, Asian consensus recommendation, and cut-off value obtained by receiver operating characteristic [ROC] curve analysis). In both groups, the baPWV value obtained using ROC curve analysis emerged as the best predictor of MACE. This predictive value was stronger in the NHIB group (hazard ratio, 5.80; 95% confidence interval, 2.30–14.65; <i>p</i> < 0.001) than in the MAB group (hazard ratio, 3.30; 95% confidence interval, 1.57–6.92; <i>p</i> = 0.002). Conclusions: baPWV was associated with future MACE incidence in both NHIB and MAB groups. Since baPWV is simple and cost-effective to measure, it could be efficiently used as a risk stratification tool for individuals with low SES. |
| first_indexed | 2024-03-11T11:26:34Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T11:26:34Z |
| publishDate | 2023-11-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-acce48f22b38421cb2ea3b443e1e657b2023-11-10T15:06:59ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011221694310.3390/jcm12216943The Prognostic Value of Arterial Stiffness According to Socioeconomic StatusWoo-Hyun Lim0Hack-Lyoung Kim1Hyun Sung Joh2Jae-Bin Seo3Sang-Hyun Kim4Joo-Hee Zo5Myung-A Kim6Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaBackground: Individuals of low socioeconomic status (SES) often exhibit increased cardiovascular risk factors and a worse prognosis. We conducted this study to ascertain whether brachial-ankle pulse wave velocity (baPWV), a straightforward and reliable measure of arterial stiffness, can hold prognostic value for people with low SES. Methods: We retrospectively analyzed a total of 1266 subjects (mean age 64.6 ± 11.6 years; 47.2% female) without documented cardiovascular disease who had undergone baPWV measurement. The subjects included 633 National Health Insurance Beneficiaries (NHIB) and 633 Medical Aid Beneficiaries (MAB), matched for major clinical features through a 1:1 propensity score matching method. Major adverse cardiovascular events (MACE), such as death, non-fatal myocardial infarction, non-fatal ischemic stroke, coronary revascularization, and heart failure necessitating admission, were assessed during the clinical follow-up. Results: During a median follow-up period of 4.2 years (interquartile range, 2.2–5.7 years), there were 77 MACE cases (6.1%). In multivariable Cox regression analyses, baPWV was identified as a significant predictor of MACE in both groups, regardless of the use of three different baPWV criteria (median value, Asian consensus recommendation, and cut-off value obtained by receiver operating characteristic [ROC] curve analysis). In both groups, the baPWV value obtained using ROC curve analysis emerged as the best predictor of MACE. This predictive value was stronger in the NHIB group (hazard ratio, 5.80; 95% confidence interval, 2.30–14.65; <i>p</i> < 0.001) than in the MAB group (hazard ratio, 3.30; 95% confidence interval, 1.57–6.92; <i>p</i> = 0.002). Conclusions: baPWV was associated with future MACE incidence in both NHIB and MAB groups. Since baPWV is simple and cost-effective to measure, it could be efficiently used as a risk stratification tool for individuals with low SES.https://www.mdpi.com/2077-0383/12/21/6943arterial stiffnessbrachial-ankle pulse wave velocitymedical aidnational health insuranceprognosissocioeconomic status |
| spellingShingle | Woo-Hyun Lim Hack-Lyoung Kim Hyun Sung Joh Jae-Bin Seo Sang-Hyun Kim Joo-Hee Zo Myung-A Kim The Prognostic Value of Arterial Stiffness According to Socioeconomic Status Journal of Clinical Medicine arterial stiffness brachial-ankle pulse wave velocity medical aid national health insurance prognosis socioeconomic status |
| title | The Prognostic Value of Arterial Stiffness According to Socioeconomic Status |
| title_full | The Prognostic Value of Arterial Stiffness According to Socioeconomic Status |
| title_fullStr | The Prognostic Value of Arterial Stiffness According to Socioeconomic Status |
| title_full_unstemmed | The Prognostic Value of Arterial Stiffness According to Socioeconomic Status |
| title_short | The Prognostic Value of Arterial Stiffness According to Socioeconomic Status |
| title_sort | prognostic value of arterial stiffness according to socioeconomic status |
| topic | arterial stiffness brachial-ankle pulse wave velocity medical aid national health insurance prognosis socioeconomic status |
| url | https://www.mdpi.com/2077-0383/12/21/6943 |
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