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ID 110959
Title Alternative
心血管イベント予測のための上腕動脈収縮期血圧左右差の最適なカットオフ値の開発と検証
Author
Hirono, Akira Tokushima University
Kageyama, Norihito Tokushima Prefectural Miyoshi Hospital
Sumitomo, Masayuki Tokushima Prefectural Miyoshi Hospital
Fujinaga, Hiroyuki Tokushima Prefectural Central Hospital
Keywords
Inter-arm systolic blood pressure difference
cardiovascular risk
optimal cut-off value
ankle-brachial blood pressure index
Content Type
Thesis or Dissertation
Description
Background: 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.
Methods: 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.
Results: 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 5 mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p < 0.001). In the validation cohort, the presence of a large IAD (IAD ≥ 5 mmHg) was significantly associated with the primary endpoint (p = 0.021).
Conclusions: IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5 mmHg.
Journal Title
Journal of Cardiology
ISSN
09145087
NCID
AN10070473
Publisher
Japanese College of Cardiology|Elsevier
Volume
71
Issue
1
Start Page
24
End Page
30
Published Date
2017-08-19
Remark
内容要旨・審査要旨・論文本文の公開
本論文は, 著者Akira Hironoの学位論文として提出され, 学位審査・授与の対象となっている。
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3115号
Diploma Number
甲医第1350号
Granted Date
2017-10-26
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences