Relationship of Non-Invasive Arterial Stiffness Parameters with 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Post-COVID-19 Patients—The Results of a Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Group
2.2. ASCVD Risk Assessment
2.3. Arterial Stiffness Measurement
- Peak-to-peak time (PPT, m/s) indicates the time elapsed from the systolic to the diastolic peak of the DVP wave;
- The stiffness index (SI, m/s) reflects the time between the peak systolic and diastolic wave and is indexed to the subject’s height (calculated as the height divided by the PPT time);
- The reflection index (RI, %) assesses what percentage of the systolic wave amplitude is the diastolic wave amplitude (calculated as the “b” wave amplitude divided by the “a” wave amplitude and multiplied by 100%).
2.4. Statistical Analysis
3. Results
3.1. General Characteristics of the Study Group
3.2. Relationship of the Arterial Stiffness Parameters with ASCVD Risk in the Entire Cohort
3.3. Relationship of the Arterial Stiffness Parameters with the SCORE2 Algorithm in the Healthy Group
3.4. Usefulness of Arterial Stiffness Cut-Off Points Compared to the Individual Classic Risk Factors in the Healthy Group
4. Discussion
Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameters | All Participants 203 (100.0%) | ASCVD-Related Events Risk Groups | p-Value for Trend | |||
---|---|---|---|---|---|---|
Low/Moderate (1) 30 (14.8%) | High (2) 111 (54.7%) | Very High (3) 62 (30.5%) | ||||
Age (years), M (lower–upper quartile) | 60.0 (55.0–63.0) | 51.0 (47.0–58.0) | 59.0 (54.0–62.0) | 62.0 (60.0–65.0) | <0.001 (1) ≠ (2) (3) (2) ≠ (3) | |
Sex, n (%) | men | 88 (43.3%) | 4 (13.3) | 50 (45.0) | 34 (54.8) | <0.001 (1) ≠ (2) (1) ≠ (3) |
women | 115 (56.7%) | 26 (86.7) | 61 (55.0) | 28 (45.2) | ||
BMI (kg/m2), M (lower–upper quartile) | 29.00 (26.05–32.31) | 26.10 (24.22–30.06) | 29.40 (26.44–31.86) | 29.84 (26.22–33.57) | 0.019 (1) ≠ (2) (3) | |
Obesity, n (%) | 89 (43.8) | 8 (26.7) | 51 (45.9) | 30 (48.4) | 0.085 | |
Pre-existing ASCVD, n (%) | 14 (6.9) | 0.0 (0.0) | 0.0 (0.0) | 14 (22.6) | <0.001 (1) (2) ≠ (3) | |
Heart failure, n (%) | 13 (6.4%) | 2 (6.7) | 6 (5.4) | 5 (8.1) | 0.677 | |
Chronic pulmonary disease, n (%) | 22 (10.8) | 8 (26.7) | 8 (7.2) | 6 (9.7) | 0.086 | |
Atrial fibrillation, n (%) | 6 (3.0) | 1 (3.3) | 3 (2.7) | 2 (3.2) | 0.973 | |
Hypertension, n (%) | 122 (60.1) | 8 (26.7) | 70 (63.1) | 44 (71.0) | 0.002 (1) ≠ (2) (1) ≠ (3) | |
Diabetes, n (%) | 44 (21.7) | 0 (0.0) | 37 (33.3) | 7 (11.3) | 0.987 (1) ≠ (2) (2) ≠ (3) | |
Chronic kidney disease *, n (%) | 9 (4.4) | 1 (3.3) | 4 (3.6) | 4 (6.5) | 0.375 | |
Dyslipidemia #, n (%) | 106 (52.2) | 9 (30.0) | 61 (55.0) | 36 (58.1) | 0.027 (1) ≠ (2) (1) ≠ (3) | |
Current smokers, n (%) | 21 (10.3) | 0 (0.0) | 10 (9.0) | 11 (17.7) | 0.008 (1) ≠ (3) | |
Beta blockers | 93 (45.8) | 12 (40.0) | 48 (43.2) | 33 (53.2) | 0.143 | |
ACE-I/ARB | 72 (35.5) | 3 (10.0) | 38 (34.2) | 31 (50.0) | <0.001 (1) ≠ (2) (3) (2) ≠ (3) | |
MRA | 9 (4.4) | 0 (0.0) | 2 (1.8) | 7 (11.3) | 0.004 (1) ≠ (3) (2) ≠ (3) | |
Loop diuretics | 10 (4.9) | 1 (3.3) | 6 (5.4) | 3 (4.8) | 0.818 | |
Acetylsalicylic acid | 38 (18.7) | 3 (10.0) | 12 (10.8) | 23 (37.1) | <0.001 (1) ≠ (3) (2) ≠ (3) |
Parameters | All Participants 203 (100.0%) | ASCVD-Related Events Risk Groups | |||
---|---|---|---|---|---|
low/Moderate (1) 30 (14.8%) | High (2) 111 (54.7%) | Very High (3) 62 (30.5%) | p-Value for Trend | ||
SI (m/s), M (lower–upper quartile) | 8.62 (7.40–9.96) | 8.07 (7.10–8.73) | 8.70 (7.40–10.03) | 9.27 (7.57–10.44) | 0.003 (1) ≠ (2) (1) ≠ (3) |
RI (%), M (lower–upper quartile) | 57.80 (44.53–68.60) | 51.40 (39.40–65.60) | 57.20 (43.65–68.40) | 59.00 (50.40–72.40) | 0.026 |
SBP (mmHg), M (lower–upper quartile) | 131.00 (119.00–144.25) | 122.00 (112.00–133.00) | 132.00 (116.25–144.75) | 133.50 (125.00–146.50) | 0.005 (1) ≠ (2) (1) ≠ (3) |
DBP (mmHg), M (lower–upper quartile) | 80.00 (75.00–85.00) | 77.00 (70.00–82.00) | 80.00 (75.00–87.00) | 80.00 (76.00–85.00) | 0.079 |
PP (mmHg), M (lower–upper quartile) | 55.00 (46.00–65.00) | 45.50 (40.00–57.00) | 54.00 (46.00–60.75) | 60.00 (51.00–67.00) | <0.001 (1) ≠ (2) (3) (2) ≠ (3) |
Creatinine (mg/dL), M (lower–upper quartile) | 0.93 (0.85–1.03) | 0.85 (0.83–0.97) | 0.95 (0.86–1.07) | 0.95 (0.85–1.02) | 0.098 (1) ≠ (2) (1) ≠ (3) |
Fasting glucose (mg/dL), M (lower–upper quartile) | 87.15 (80.40–97.10) | 80.75 (75.80–84.90) | 89.20 (81.60–99.88) | 88.70 (80.60–97.18) | 0.018 (1) ≠ (2) (1) ≠ (3) |
CRP (mg/dL), M (lower–upper quartile) | 2.30 (1.30–4.73) | 2.10 (1.10–4.40) | 2.30 (1.33–4.68) | 2.35 (1.35–4.85) | 0.429 |
TC (mg/dL), M (lower–upper quartile) | 228.70 (192.50–277.58) | 225.15 (192.80–275.90) | 223.50 (192.20–272.63) | 241.15 (192.55–284.75) | 0.419 |
HDL-C (mg/dL), M (lower–upper quartile) | 63.80 (49.08–82.48) | 73.75 (58.40–91.30) | 61.10 (46.48–77.55) | 62.40 (45.25–89.20) | 0.131 (1) ≠ (2) (1) ≠ (3) |
LDL-C (mg/dL), M (lower–upper quartile) | 142.95 (118.60–171.10) | 146.95 (116.00–171.10) | 139.00 (118.83– 169.70) | 154.30 (119.40–177.30) | 0.429 |
TG (mg/dL), M (lower–upper quartile) | 169.80 (126.00–229.93) | 126.75 (102.00–154.80) | 182.40 (135.08–246.45) | 170.40 (136.450–225.30) | 0.012 (1) ≠ (2) (1) ≠ (3) |
Non-HDL-C (mg/dL), M (lower–upper quartile) | 165.90 (130.78–201.40) | 143.65 (124.70–184.10) | 168.10 (132.95–196.50) | 174.90 (133.65–213.60) | 0.031 |
Parameters with the Optimal Criterion Value | Relationship with Low/Moderate ASCVD-Related Event Risk According to the SCORE2 Algorithm in the Apparently Healthy Cohort | |||||
---|---|---|---|---|---|---|
Full Model | Stepwise Regression p < 0.001; Nagelkerke R2: 0.684 | |||||
Coefficient | OR (95% CI) | p-Value | Coefficient | Standard Error | p-Value | |
Age (years) | 0.247 | 1.28 (1.179–1.391) | <0.001 | 0.325 | 0.066 | <0.001 |
Sex (woman) | −0.788 | 0.45 (0.201–1.031) | 0.059 | −1.773 | 0.785 | 0.024 |
Smoking status (never smoker) | −0.928 | 0.40 (0.170–0.918) | 0.031 | not significant in the model | ||
PP ≤ 50 (mmHg) | −1.393 | 0.25 (0.114–0.539) | <0.001 | −1.862 | 0.636 | 0.003 |
SI ≤ 9.0 (m/s) | −2.169 | 0.11 (0.038–0.345) | <0.001 | −1.633 | 0.811 | 0.044 |
RI ≤ 54 (%) | −0.969 | 0.38 (0.178–0.808) | 0.012 | not significant in the model | ||
SBP < 120 (mmHg) | −0.439 | 0.64 (0.297–1.400) | 0.267 | not included in the model | ||
DBP < 80 (mmHg) | −0.649 | 0.52 (0.246–1.112) | 0.092 | not significant in the model | ||
BMI < 25.0 (kg/m2) | −0.346 | 0.71 (0.297–1.687) | 0.435 | not included in the model | ||
TC < 190 (mg/dL) | −0.304 | 0.74 (0.287–1.896) | 0.528 | not included in the model | ||
LDL-C < 115 (mg/dL) | −0.461 | 0.63 (0.241–1.649) | 0.347 | not included in the model | ||
TG < 150 (mg/dL) | −0.921 | 0.40 (0.187–0.848) | 0.017 | −1.653 | 0.666 | 0.013 |
Non-HDL-C < 145 (mg/dL) | −1.260 | 0.28 (0.130–0.620) | 0.002 | not significant in the model |
Parameters with the Optimal Criterion Value | Relationship with Very High ASCVD-Related Event Risk According to the SCORE2 Algorithm in the Apparently Healthy Cohort | |||||
---|---|---|---|---|---|---|
Full Model | Stepwise Regression p < 0.001; Nagelkerke R2: 0.7235 | |||||
Coefficient | OR (95% CI) | p-Value | Coefficient | Standard Error | p-Value | |
Age (years) | 0.304 | 1.36 (1.198–1.532) | <0.001 | 0.487 | 0.106 | <0.001 |
Sex (man) | 0.598 | 1.82 (0.860–3.847) | 0.118 | not significant in the model | ||
Smoking status (current smoker) | 1.088 | 2.97 (0.967–9.114) | 0.057 | 2.987 | 1.095 | 0.006 |
PP >56.0 (mmHg) | 1.714 | 5.55 (2.428–12.692) | <0.001 | 3.090 | 0.752 | <0.001 |
SI > 9.0 (m/s) | 1.455 | 4.29 (1.963–9.356) | <0.001 | not significant in the model | ||
RI > 68.6 (%) | 1.033 | 2.81 (1.276–6.188) | 0.010 | 1.714 | 0.735 | 0.020 |
SBP ≥ 140 (mmHg) | 0.972 | 2.64 (1.223–5.710) | 0.013 | not significant in the model | ||
DBP ≥ 90 (mmHg) | 0.943 | 2.57 (0.968–6.807) | 0.058 | 2.668 | 0.930 | 0.004 |
BMI ≥ 30.0 (kg/m2) | 0.306 | 1.36 (0.641–2.876) | 0.425 | not included in the model | ||
TC ≥ 190 (mg/dL) | 0.467 | 1.60 (0.551–4.620) | 0.390 | not included in the model | ||
LDL-C ≥ 115 (mg/dL) | 0.331 | 1.39 (0.476–4.077) | 0.546 | not included in the model | ||
TG ≥ 150 (mg/dL) | 0.734 | 2.08 (0.935–4.640) | 0.073 | not significant in the model | ||
Non-HDL-C ≥ 145 (mg/dL) | 1.173 | 3.23 (1.237–8.436) | 0.017 | not significant in the model |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Loboda, D.; Sarecka-Hujar, B.; Nowacka-Chmielewska, M.; Szoltysek-Boldys, I.; Zielinska-Danch, W.; Gibinski, M.; Wilczek, J.; Gardas, R.; Grabowski, M.; Lejawa, M.; et al. Relationship of Non-Invasive Arterial Stiffness Parameters with 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Post-COVID-19 Patients—The Results of a Cross-Sectional Study. Life 2024, 14, 1105. https://doi.org/10.3390/life14091105
Loboda D, Sarecka-Hujar B, Nowacka-Chmielewska M, Szoltysek-Boldys I, Zielinska-Danch W, Gibinski M, Wilczek J, Gardas R, Grabowski M, Lejawa M, et al. Relationship of Non-Invasive Arterial Stiffness Parameters with 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Post-COVID-19 Patients—The Results of a Cross-Sectional Study. Life. 2024; 14(9):1105. https://doi.org/10.3390/life14091105
Chicago/Turabian StyleLoboda, Danuta, Beata Sarecka-Hujar, Marta Nowacka-Chmielewska, Izabela Szoltysek-Boldys, Wioleta Zielinska-Danch, Michal Gibinski, Jacek Wilczek, Rafal Gardas, Mateusz Grabowski, Mateusz Lejawa, and et al. 2024. "Relationship of Non-Invasive Arterial Stiffness Parameters with 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Post-COVID-19 Patients—The Results of a Cross-Sectional Study" Life 14, no. 9: 1105. https://doi.org/10.3390/life14091105