Arterial Stiffness Associated With Long-term Major Adverse Cardiac Events in Patients With Primary Aldosteronism
Authors' conclusion
Our study found that 13.6% of patients with PA developed MACEs after a median follow-up of 5.8 years. Our findings highlight the potential utility of baPWV as a tool for risk stratification in patients with PA in primary prevention, whereas adrenalectomy appears to mitigate this risk regardless of baPWV. The measurement of baPWV could be a valuable addition to hypertension screening programs for primary prevention, providing additional predictive information for the potential occurrence of MACEs.
Study context
- Population
- Patients with PAincluded in final analysis
- Participants
- 830 patients
- Exposure
- Higher vs lower brachial-ankle pulse wave velocity
- Outcome
- Incident MACE in relation to baPWV
- Follow-up
- Median 5.8 years
Methodological detailsprimary prevention design
- Primary prevention design
Main finding
As reported in the abstract
Patients developing incident MACE
113
13.6%
Crude MACE rate
23.2 per 1000 person-years
Brachial-ankle pulse wave velocity (baPWV) as independent risk factor, adjusted HR (multivariable Cox)
1.01
P = .028
baPWV cut-off 2000 cm/s, HR (mortality as competing risk)
1.81
P = .024
Observational data: associations, not effects.
Further findings
Subgroup: mineralocorticoid receptor antagonist users with high baPWV
- HR for incident MACE
- 3.34 (P < .001)
Subgroup: adrenalectomy
- Risk not significant
- P = 0.062
Adding baPWV to cardiovascular Framingham risk score
- Category-free net reclassification index
- 0.308 (P < .001)
Original publication
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