Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular events
Background: The high incidence rate of cardiovascular (CV) events had led to a comprehensive appraisal for identifying patients who are at risk for CV disease. However, CV traditional risk factors, such as Framingham risk score (FRS), failed exhaustively to predict CV events. Methods: 402 participan...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-04-01
|
| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906721000166 |
| _version_ | 1818728723715719168 |
|---|---|
| author | Tao Sun Yasushi Matsuzawa Robert J. Widmer Joerg Hermann Lilach O. Lerman Amir Lerman |
| author_facet | Tao Sun Yasushi Matsuzawa Robert J. Widmer Joerg Hermann Lilach O. Lerman Amir Lerman |
| author_sort | Tao Sun |
| collection | DOAJ |
| description | Background: The high incidence rate of cardiovascular (CV) events had led to a comprehensive appraisal for identifying patients who are at risk for CV disease. However, CV traditional risk factors, such as Framingham risk score (FRS), failed exhaustively to predict CV events. Methods: 402 participants (mean age, 58 [12] years; 45% male) using fingertip peripheral artery tonometry at Mayo Clinic in Rochester, Minnesota, were recruited in the present study. Measurements included reactive hyperemia index (RHI) and pain-induced peripheral artery tonometry (PIPAT). Results: After a median follow-up of 3.8 (2.7–7.7) years, 95 CV events occurred. Both first minute PIPAT and RHI were independently associated with events (hazard ratio [HR], 0.77 [95% CI, 0.61–0.98]; P = 0.038 and HR, 0.75 [95% CI, 0.59–0.96]; P = 0.019, respectively). The C statistic values of FRS, FRS + first minute PIPAT, FRS + RHI, and FRS + RHI + first minute PIPAT were 0.704, 0.722, 0.694, and 0.726, respectively. Furthermore, the addition of first minute PIPAT, RHI, and first minute PIPAT + RHI to FRS results in net reclassification improvement (NRI) in the intermediate-risk group (18.1%, P = 0.031; 18.1%, P = 0.035; 21%, P = 0.013). Conclusion: First minute PIPAT is a risk marker for adverse CV. Addition of first minute PIPAT to FRS increased the discrimination in the receiver operating characteristic analysis. It also increased NRI compared with FRS alone. |
| first_indexed | 2024-12-17T22:34:32Z |
| format | Article |
| id | doaj.art-be884fc9da704a4da41a45511de58484 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-17T22:34:32Z |
| publishDate | 2021-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-be884fc9da704a4da41a45511de584842022-12-21T21:30:08ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672021-04-0133100728Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular eventsTao Sun0Yasushi Matsuzawa1Robert J. Widmer2Joerg Hermann3Lilach O. Lerman4Amir Lerman5Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA; Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA; Corresponding author at: Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.Background: The high incidence rate of cardiovascular (CV) events had led to a comprehensive appraisal for identifying patients who are at risk for CV disease. However, CV traditional risk factors, such as Framingham risk score (FRS), failed exhaustively to predict CV events. Methods: 402 participants (mean age, 58 [12] years; 45% male) using fingertip peripheral artery tonometry at Mayo Clinic in Rochester, Minnesota, were recruited in the present study. Measurements included reactive hyperemia index (RHI) and pain-induced peripheral artery tonometry (PIPAT). Results: After a median follow-up of 3.8 (2.7–7.7) years, 95 CV events occurred. Both first minute PIPAT and RHI were independently associated with events (hazard ratio [HR], 0.77 [95% CI, 0.61–0.98]; P = 0.038 and HR, 0.75 [95% CI, 0.59–0.96]; P = 0.019, respectively). The C statistic values of FRS, FRS + first minute PIPAT, FRS + RHI, and FRS + RHI + first minute PIPAT were 0.704, 0.722, 0.694, and 0.726, respectively. Furthermore, the addition of first minute PIPAT, RHI, and first minute PIPAT + RHI to FRS results in net reclassification improvement (NRI) in the intermediate-risk group (18.1%, P = 0.031; 18.1%, P = 0.035; 21%, P = 0.013). Conclusion: First minute PIPAT is a risk marker for adverse CV. Addition of first minute PIPAT to FRS increased the discrimination in the receiver operating characteristic analysis. It also increased NRI compared with FRS alone.http://www.sciencedirect.com/science/article/pii/S2352906721000166Cardiovascular eventsFramingham risk scorePain-induced peripheral artery tonometryReactive hyperemia index |
| spellingShingle | Tao Sun Yasushi Matsuzawa Robert J. Widmer Joerg Hermann Lilach O. Lerman Amir Lerman Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular events International Journal of Cardiology: Heart & Vasculature Cardiovascular events Framingham risk score Pain-induced peripheral artery tonometry Reactive hyperemia index |
| title | Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular events |
| title_full | Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular events |
| title_fullStr | Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular events |
| title_full_unstemmed | Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular events |
| title_short | Predictive value of vascular response to cuff inflation–induced pain in the control arm for adverse cardiovascular events |
| title_sort | predictive value of vascular response to cuff inflation induced pain in the control arm for adverse cardiovascular events |
| topic | Cardiovascular events Framingham risk score Pain-induced peripheral artery tonometry Reactive hyperemia index |
| url | http://www.sciencedirect.com/science/article/pii/S2352906721000166 |
| work_keys_str_mv | AT taosun predictivevalueofvascularresponsetocuffinflationinducedpaininthecontrolarmforadversecardiovascularevents AT yasushimatsuzawa predictivevalueofvascularresponsetocuffinflationinducedpaininthecontrolarmforadversecardiovascularevents AT robertjwidmer predictivevalueofvascularresponsetocuffinflationinducedpaininthecontrolarmforadversecardiovascularevents AT joerghermann predictivevalueofvascularresponsetocuffinflationinducedpaininthecontrolarmforadversecardiovascularevents AT lilacholerman predictivevalueofvascularresponsetocuffinflationinducedpaininthecontrolarmforadversecardiovascularevents AT amirlerman predictivevalueofvascularresponsetocuffinflationinducedpaininthecontrolarmforadversecardiovascularevents |