Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events

• Material Type: 博士論文
• Title: Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events
• Author/Editor: Hirono, Akira; Kusunose, Kenya; Kageyama, Norihito; Sumitomo, Masayuki; Abe, Masahiro; Fujinaga, Hiroyuki; Sata, Masataka
• Author Heading: Hirono, Akira; Kusunose, Kenya; Kageyama, Norihito; Sumitomo, Masayuki; Abe, Masahiro; Fujinaga, Hiroyuki; Sata, Masataka
• Publication, Distribution, etc.: Japanese College of Cardiology|Elsevier
• Publication Date: 2017-08-19
• Publication Date (W3CDTF): 2017-08-19
• Alternative Title: 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
• Periodical title: Journal of Cardiology
• No. or year of volume/issue: 71 1
• Volume: 71
• Issue: 1
• Pages: 24-30
• ISSN (Periodical Title): ISSN : 0914-5087
• Degree grantor/type: 徳島大学
• Date Granted: 2017-10-26
• Dissertation Number: 甲第3115号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Inter-arm systolic blood pressure difference; cardiovascular risk; optimal cut-off value; ankle-brachial blood pressure index
• Target Audience: 一般
• Note (General): 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.
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.jjcc.2017.06.010
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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