Prognostic value of arterial stiffness according to the cardiovascular risk profiles

It is not clear whether the influence of arterial stiffness depends on the subject's cardiovascular risk status. This study was performed to assess the prognostic value of arterial stiffness according to different cardiovascular risk profiles. A total of 11,767 subjects (61 years and 58% males) who underwent brachial-ankle pulse wave velocity (baPWV) measurement were retrospectively analyzed. Subjects were stratified into three groups: (1) those with traditional risk factor <= 1 and without atherosclerotic cardiovascular disease (ASCVD), (2) those with traditional risk factors >= 2 and without ASCVD, or (3) those with documented ASCVD. Composite events of cardiac death, non-fatal myocardial infarction, coronary revascularization and stroke were assessed during the clinical follow-up period. Compared to patients with risk factor <= 1, those with risk factor >= 2 and those with ASCVD were older, and more frequently had unfavorable laboratory findings, and higher baPWV values. During the median follow-up of 1329 days (interquartile range, 570-1,965 days), there were 350 composite events (3.0%). In multivariable Cox regression analyses, higher baPWV value was independently associated with higher incidence rate of composite events even after controlling for potential confounders in all three groups (P < 0.05 for each). In this study, it was found that baPWV was independently associated with the occurrence of cardiovascular events irrespective of baseline cardiovascular risk profiles, suggesting that baPWV is useful for risk stratification in mass screening.