Arterial dysfunction has been linked to decline in cardiac function and increased risk of cardiovascular disease events. We calculated the value of arterial function, measured at baseline (2000-2002), in predicting time to first coronary heart disease (CHD) event (median follow-up, 10.2 years) among participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Measures included the following: C1 and C2, derived from diastolic pulse contour analysis from the radial artery blood pressure waveform obtained by tonometry (n = 6,336); carotid distensibility and Young's elastic modulus at the carotid artery, derived from carotid artery ultrasonography (n = 6,531 and 6,528); and aortic distensibility, measured using cardiac magnetic resonance imaging (n = 3,677). After adjustment, the hazard ratio for a CHD event per standard-deviation increment in arterial function was 0.97 (95% confidence interval (CI): 0.86, 1.10) for C1 , 0.73 (95% CI: 0.63, 0.86) for C2 , 0.98 (95% CI: 0.86, 1.11) for carotid distensibility, 0.99 (95% CI: 0.90, 1.09) for Young's modulus, and 0.90 (95% CI: 0.74, 1.10) for aortic distensibility. We examined the area under the receiver operating characteristic curve for the model with full adjustment plus the addition of each measure individually. C2 provided additional discrimination for the prediction of CHD (area under the curve = 0.736 vs. 0.743; P = 0.04). Lower C2 was associated with a higher risk of future CHD events.
Bibliographical noteFunding Information:
MESA was supported by the National Heart, Lung, and Blood Institute (contracts HSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and R01-HL-098382). This work was also supported in part by the Environmental Protection Agency (award RD831697) and the National Institute of Environmental Health Sciences (grants P50ES015915, T32ES015459, and K24ES013195). This publication was developed under a STAR research assistance agreement awarded by the Environmental Protection Agency (award RD831697). This publication was supported by the National Institute of Environmental Health Sciences (grants P50ES015915, T32ES015459, and K24ES013195). We thank the MESA investigators and staff. A full list of investigators can be found at http://www.mesa-nhlbi.org. This publication has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors, and the EPA does not endorse any products or commercial services mentioned in this publication. D.V. is a consultant for Consumable Science, Inc. The other authors report no conflicts.
- Coronary disease
- Vascular stiffness