Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events
| Autor: | Masataka Sata, Kenya Kusunose, Norihito Kageyama, Akira Hirono, Hiroyuki Fujinaga, Masahiro Abe, Masayuki Sumitomo |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Systole Blood Pressure 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Clinical endpoint Humans 030212 general & internal medicine Risk factor Aged Aged 80 and over Receiver operating characteristic Proportional hazards model business.industry Hazard ratio Blood Pressure Determination Middle Aged Confidence interval Blood pressure Cardiovascular Diseases Cohort Arm Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiology. 71:24-30 |
| ISSN: | 0914-5087 |
| Popis: | An inter-arm systolic blood pressure difference (IAD) is associated with cardiovascular disease. The aim of this study was to develop and validate the optimal cut-off value of IAD as a predictor of major adverse cardiac events in patients with arteriosclerosis risk factors.From 2009 to 2014, 1076 patients who had at least one cardiovascular risk factor were included in the analysis. We defined 700 randomly selected patients as a development cohort to confirm that IAD was the predictor of cardiovascular events and to determine optimal cut-off value of IAD. Next, we validated outcomes in the remaining 376 patients as a validation cohort. The blood pressure (BP) of both arms measurements were done simultaneously using the ankle-brachial blood pressure index (ABI) form of automatic device. The primary endpoint was the cardiovascular event and secondary endpoint was the all-cause mortality.During a median period of 2.8 years, 143 patients reached the primary endpoint in the development cohort. In the multivariate Cox proportional hazards analysis, IAD was the strong predictor of cardiovascular events (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, p=0.005). The receiver operating characteristic curve revealed that 5mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p0.001). In the validation cohort, the presence of a large IAD (IAD ≥5mmHg) was significantly associated with the primary endpoint (p=0.021).IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5mmHg. |
| Databáze: | OpenAIRE |
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