Prediction of Cardiovascular Events and All-Cause Mortality With Brachial-Ankle Elasticity Index: A Systematic Review and Meta-Analysis

C. Vlachopoulos, K. Aznaouridis, D. Terentes-Printzios, N. Ioakeimidis, C. Stefanadis
2012 Hypertension  
Brachial-ankle elasticity index (baEI; also known as brachial-ankle pulse wave velocity) has been proposed as a surrogate end point for cardiovascular disease. We performed a meta-analysis of longitudinal cohort studies for determining the ability of baEI to predict risk of cardiovascular events and all-cause mortality and dissecting factors influencing this predictive ability. Multiple online databases, reference lists from retrieved articles, and abstracts from international cardiovascular
more » ... l cardiovascular conventions were searched until April 2012. Longitudinal cohort studies that reported associations of baEI with clinical risk were included. Of the 18 studies included (8169 participants; mean follow-up, 3.6 years), 15 reported results on total cardiovascular events (5544 individuals), 7 on cardiovascular mortality (2274 individuals), and 9 on all-cause mortality (5097 individuals). The pooled relative risks for total cardiovascular events, cardiovascular mortality, and all-cause mortality were 2.95 (95% CI, 1.63-5.33), 5.36 (95% CI, 2.17-13.27), and 2.45 (95% CI, 1.56 -3.86), respectively, for subjects with high versus low baEI (all PϽ0.001). An increase in baEI by 1 m/s corresponded with an increase of 12%, 13%, and 6% in total cardiovascular events, cardiovascular mortality, and all-cause mortality, respectively. We conclude that baEI is associated with increased risk of total cardiovascular events and all-cause mortality. Issues such as expansion of data to non-Asian populations, validation of path length estimation, determination of reference values, and prospective comparison with carotid-femoral pulse wave velocity remain to be resolved. (Hypertension. 2012;60:556-562.) • Online Data Supplement
doi:10.1161/hypertensionaha.112.194779 pmid:22733468 fatcat:6pabaqilcfhifnnjmxkehuaclq