Welcome to InCirculation.net
InCirculation.net is a professional cardiovascular resource intended for a global audience of specialists, generalists, researchers, and other healthcare professionals
Cardiovascular news provides daily news updates to help you stay informed.
Brachial-ankle pulse wave velocity predicts prognosis for CAD patients with diabetes
16 August 2010
MedWire News: Brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, is an effective predictor of prognosis in coronary artery disease (CAD) patients with Type 2 diabetes, report Japanese researchers.
Over 30% of patients with CAD also have Type 2 diabetes, explain Michinari Nakamura (The Cardiovascular Institute, Minato-ku, Tokyo) and colleagues. They add that such patients have double the risk for adverse cardiovascular (CV) events compared with CAD patients without diabetes making it important to try to improve risk stratification for these individuals.
Nakamura and team assessed the efficacy of baPWV for prediction of all-cause death, or a composite endpoint of death, nonfatal myocardial infarction (MI), repeat revascularization, or re-admission for heart failure (HF) in 564 Japanese CAD patients participating in the Shinken Database cohort study.
Of these, 191 had Type 2 diabetes and 373 did not. The mean follow-up period for the study was 25.4 months.
Patients with diabetes and CAD were divided into two groups based on baPWV: high baPWV was defined as a reading at or above 1730 cm/s, and low baPWV as a reading below 1730 cm/s. The patients with CAD alone were used as a comparison group (median baPWV=1671 cm/s).
Over the follow-up period, 2.1% of the diabetic CAD patients with low baPWV compared with 10.4% of those with high baPWV died of any cause. A corresponding 23.2% compared with 38.5% experienced the composite endpoint. Both these between group differences were significant.
Three-year CV event-free survival occurred in 72.8% of diabetic CAD patients with low baPWV, compared with 51.3% of diabetic CAD patients with high baPWV, and 80.8% of the nondiabetic CAD patients.
Multivariate analysis showed that a high versus low baPWV was significantly associated with a poorer clinical outcome (increased risk for either death or composite endpoint; hazard ratio=1.97) in patients with CAD and Type 2 diabetes.
The researchers conclude: “We believe that risk stratification of short term prognosis with baPWV can help target careful follow-up and more intensive medication therapy for patients at higher risk for future cardiovascular events.”
The results of this study are published in the journal Hypertension Research.
Your opinion matters - help to shape the future of InCirculation.net by completing our short survey. 
