Prognostic role of flow-mediated dilation and cardiac risk factors in post-menopausal women
Prognostic role of flow-mediated dilation and cardiac risk factors in post-menopausal women
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DOI：
10.1016/j.jacc.2007.11.044
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发表时间：
2008-03-11
影响因子：
24
通讯作者：
Modena, Maria Grazia
中科院分区：
文献类型：
--
作者：
Rossi, Rosario;Nuzzo, Annachiara;Modena, Maria Grazia
目的 本研究的目的是在一组最初无症状的绝经后妇女中检查肱动脉血流介导的扩张 (FMD) 与心血管事件之间的关联，并对主要心血管危险因素的存在进行调整。 背景 传统的主要心血管危险因素（吸烟、高胆固醇血症、高血压和糖尿病）无法解释近 50% 的心血管事件。确定临床事件发生的未来风险程度是有效一级预防的重点。利用肱动脉 FMD 的无创测量来评估内皮功能，可以作为个体化高危患者的筛查工具。方法 我们对 2,264 名年龄 54 +/- 6 岁的绝经后妇女进行了一项前瞻性研究。随访时间为 45 +/- 13 个月（范围 6 至 65 个月）。 结果 在观察期间，记录了 90 起主要事件。对于处于 FMD 高、中、低三分位的女性，风险调整后的相对风险值分别为 1.0、1.33（95% 置信区间 [CI] 1.09 至 4.09）和 4.42（95% CI 2.97 至 8.01）（趋势 p < 0.0001）。处于较低三分位数的女性的事件发生率 (FMD
Objectives The aim of this study was to examine the association between brachial artery flow-mediated dilation (FMD) and cardiovascular events in a cohort of initially asymptomatic post-menopausal women, with adjustment for the presence of the major cardiovascular risk factors.Background Conventional major cardiovascular risk factors (cigarette smoking, hypercholesterolemia, hypertension, and diabetes) fail to explain nearly 50% of cardiovascular events. Defining the magnitude of future risk for the development of clinical events is a major focus of effective primary prevention. Evaluation of endothelial function, utilizing the noninvasive measurement of the brachial artery FMD, may serve as a screening tool to individualize high-risk patients.Methods We conducted a prospective study on 2,264 post-menopausal women, age 54 +/- 6 years. The length of the follow-up was 45 +/- 13 months (range 6 to 65 months).Results During observation, 90 major events were recorded. Risk-adjusted relative risk values resulted 1.0, 1.33 (95% confidence interval [CI] 1.09 to 4.09), and 4.42 (95% Cl 2.97 to 8.01) for women in the higher, intermediate, and lower tertile of FMD, respectively (p < 0.0001 for trend). The event rate for women in the lower tertile (FMD