Aims Progressive arterial stiffening, as a marker of arterial aging, may reach a plateau in elderly patients and may thus lose its clinical utility. This phenomenon may be more prominent in high-risk patients. We aimed to investigate if carotid-to-femoral pulse wave velocity (cf-PWV) is related to coronary artery disease (CAD) and diastolic dysfunction in elderly high-risk patients as compared to a control group of younger individuals. Methods One-hundred and ninety-two high-risk stable patients who underwent coronary artery angiography and assessment of cf-PWV were consecutively recruited. Indices of diastolic dysfunction were also measured by echocardiography, including the volume of the left atrium and the ratio of early transmitral peak velocity (E) to the mitral annular early diastolic velocity (E’). Results Increased cf-PWV was associated with the presence of CAD [odds ratio (OR) 1.34, P = 0.02], number of diseased coronary vessels (OR 1.17, P = 0.029) and CAD severity (P = 0.023) as assessed by Gensini score, in patients less than 65 years old after adjustment for traditional risk factors. Moreover, cf-PWV correlated with E/E’ (P = 0.019) and increased the odds by 16% (OR 1.16, P = 0.048) for more severe diastolic dysfunction in patients aged below 65 years old. None of these outcomes correlated with cf-PWV in the elderly. Conclusion In high cardiovascular risk patients, an age-dependent association of cf-PWV with CAD and diastolic dysfunction was evinced. In contrast to younger patients, these results suggest that measuring arterial stiffness in elderly high-risk patients may lack clinical value.
Background and aims: The non-coding antisense transcript for beta-secretase-1 (BACE1-AS) is a long non-coding RNA with a pivotal role in the regulation of amyloid-beta (Aβ). We aimed to explore the clinical value of BACE1-AS expression in atherosclerotic cardiovascular disease (ASCVD). Methods: Expression of BACE1-AS and its target, beta-secretase 1 (BACE1) mRNA, was measured in peripheral blood mononuclear cells (PBMCs) derived from 434 individuals [259 without established ASCVD (non-CVD), 90 with stable coronary artery disease (CAD) and 85 with acute coronary syndrome]. Intima-media thickness and atheromatous plaques evaluated by ultrasonography, as well as arterial wave reflections and pulse wave velocity were measured as markers of subclinical ASCVD. Patients were followed for a median of 52 months for major adverse cardiac events (MACE). Results: In the cross-sectional arm, BACE1-AS expression correlated with BACE1 expression (r=0.396, p<0.001) and marginally with Aβ1-40 levels in plasma (r=0.141, p=0.008). Higher BACE1-AS was associated with higher estimated CVD risk assessed by HeartScore for non-CVD subjects and by ESC clinical criteria for the total population (p<0.05 for both). BACE1-AS was associated with higher prevalence of CAD [OR=1.85 (95% CI: 1.37-2.5)], multivessel CAD [OR=1.36 (95% CI:1.06-1.75)] and with higher number of diseased vascular beds [OR=1.31, (95% CI: 1.07-1.61) for multiple diseased vascular beds] after multivariable adjustment for traditional cardiovascular risk factors. In the prospective arm, BACE1-AS was an independent predictor of MACE in high cardiovascular risk patients [adjusted HR= 1.86 per ascending tertile, (95% CI: 1.011-3.43), p=0.046]. Conclusions: BACE1-AS is associated with the incidence and severity of ASCVD.
In subjects without CVD, high consumption of SFA is related to accelerated arterial stiffening, while high consumption of MUFA and fibre and low intake of carbohydrates is associated with attenuated progression in blood pressure and arterial wave reflections, respectively. These findings expand current knowledge on the association of macronutrient consumption with arterial aging in the general population.
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