Prognostic value of pulse wave velocity for cardiovascular disease risk stratification in diabetic patients: A systematic review and meta-analysis

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM Journal of diabetes and its complications Pub Date : 2024-10-19 DOI:10.1016/j.jdiacomp.2024.108894

Siao Suan Cheong , Nazirah Samah , Nur Aishah Che Roos , Azizah Ugusman , Mohd Shawal Faizal Mohamad , Boon Cong Beh , Isa Azzaki Zainal , Amilia Aminuddin

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Abstract

Aim

Arterial stiffness, a significant cardiovascular risk marker, is particularly important in patients with diabetes mellitus (DM). Pulse wave velocity (PWV), a non-invasive measure of arterial stiffness, has emerged as an independent predictor of cardiovascular morbidity and mortality. However, its precise prognostic value in DM patients for cardiovascular risk stratification remains unclear. To address this, a systematic review was conducted.

Method

A thorough search of Ovid and Scopus databases was performed for cohort studies on PWV measurements for cardiovascular risk stratification in DM patients. Nine studies were included, examining the relationship between PWV and cardiovascular events or composite endpoints in DM patients asymptomatic of cardiovascular diseases (CVD).

Results

The review revealed that optimal PWV cutoffs to predict composite cardiovascular events ranged from 10 to 12.16 m/s (aortic PWV) and 14 to 16.72 m/s (brachial-ankle PWV). In addition, meta-analysis yielded a HR of 1.15 (95 % CI 1.07–1.24, p < 0.001, I² = 70 %) for aortic PWV in predicting cardiovascular events.

Conclusion

The assessment of arterial stiffness via PWV shows promise as an early diagnostic marker for CVD in DM patients, aiding in improved disease management. This underscores the potential of PWV in enhancing cardiovascular risk assessment and guiding clinical decisions in this high-risk population, without invasive procedures or radiation exposure.

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脉搏波速度对糖尿病患者心血管疾病风险分层的预后价值：系统回顾和荟萃分析。

目的：动脉僵化是一个重要的心血管风险指标，对糖尿病（DM）患者尤为重要。脉搏波速度（PWV）是动脉僵化的一种无创测量方法，已成为心血管发病率和死亡率的独立预测指标。然而，脉搏波速度对糖尿病患者进行心血管风险分层的确切预后价值仍不清楚。为此，我们进行了一项系统性综述：方法：对 Ovid 和 Scopus 数据库进行了全面检索，以了解有关脉搏波速度测量用于 DM 患者心血管风险分层的队列研究。共纳入了九项研究，这些研究探讨了无症状心血管疾病（CVD）的糖尿病患者的脉搏波速度与心血管事件或复合终点之间的关系：综述显示，预测复合心血管事件的最佳脉搏波速度临界值介于 10 至 12.16 m/s（主动脉脉搏波速度）和 14 至 16.72 m/s（肱踝脉搏波速度）之间。此外，荟萃分析得出主动脉脉搏波速度预测心血管事件的 HR 为 1.15（95 % CI 1.07-1.24，p 2 = 70 %）：结论：通过脉搏波速度评估动脉僵化有望成为糖尿病患者心血管疾病的早期诊断指标，有助于改善疾病管理。这凸显了脉搏波速度在加强心血管风险评估和指导高危人群临床决策方面的潜力，而且无需侵入性程序或辐射暴露。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.