3.1 INTEGRATED CENTRAL PRESSURE-STIFFNESS RISK SCORE: A NEW OPPORTUNITY FOR CARDIOVASCULAR RISK STRATIFICATION. FIRST RESULTS ON CHRONIC KIDNEY DISEASE PATIENTS

Abstract

Background: The evaluation of arterial stiffness and central haemodynamics represent a new tool of cardiovascular (CV) risk stratification. Our aim was to create an integrated central pressure-stiffness risk score (ICPS score) which incorporate the predictive potential of identical parameters. Methods: 100 chronic kidney disease patients on conservative therapy (CKD 1–5) were involved in our study. Pulse wave velocity (PWV), augmentation index (Aix), central systolic blood pressure (csys) and central pulse pressure (cPP) were measured. Patients were followed for 59.7 months and CV morbidity and mortality were registered. Patients were classified into tertiles based on their PWV, Aix, csys and cPP values. After the analysis of the predictive values of the tertiles of the identical parameters, patients were scored. One score was given, when a patient had a third tertile value of PWV, csys or cPP or a second or third tertile value of Aix. Then the CV outcome was analyzed with Cox regression analysis of the groups of patients with different scores. Results: During follow-up 37 CV events occurred. Compared with the zero-point group (n = 21), the one-point group (n = 25) did not have significantly increased odds ratio (OR) for CV events (OR: 1.10; 95% confidence interval (CI): 0.27–4.44), but the risk has been significantly elevated in the two-point group (n = 29, OR: 4.59, CI: 1.39–15.22) and it increased further in the three-point group (n = 16, OR: 9.03, CI: 2.22–36.65), as well as in the four-point group (n = 9, OR: 11.84, CI: 2.52–55.64). Conclusion: The ICPS score can help in the identification of chronic kidney disease patients with high CV risk.