Association of Vascular Aging Phenotypes with Adverse Clinical Outcomes in the Chinese Population: A Multicentre Study.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Clinical Interventions in Aging Pub Date : 2025-03-29 eCollection Date: 2025-01-01 DOI:10.2147/CIA.S485597

Ting Xu, Yucong Zhang, Yi Zhou, Lixue Yin, Xinwen Min, Shouling Wu, Cuntai Zhang, Lei Ruan

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引用次数: 0

Abstract

Purpose: This study aimed to investigate the clinical implications of vascular aging (VAg) phenotypes based on the difference between chronological age (CA) and vascular age (VA).

Patients and methods: We defined VA as the predicted age in a multivariable linear regression model including structural and functional parameters of arteries and conventional risk factors, in a multicentric, cross-sectional cohort (n=15580). According to the 10^th and 90^th percentiles of Δ-age (CA minus VA), we then classified the status of VAg into 3 phenotypes: the early VAg (EVA), the Normal VAg and the supernormal VAg (SUPERNOVA). We used Cox survival analysis to investigate the association between VAg phenotypes and the risk for adverse clinical outcomes (including all-cause death and cardiovascular disease) in an independent, prospective cohort (n=5316).

Results: In the prospective cohort (11.07 years, 927 events), when compared to the Normal VAg phenotype, EVA had an increased risk (HR: 2.43; 95% CI: 1.80-3.27) and SUPERNOVA had a decrease risk (HR: 0.75; 95% CI: 0.64-0.90) of adverse clinical outcomes, in particular stroke events. EVA also showed a higher risk of myocardial infarction (HR: 3.21, 95% CI: 1.56-6.62) and all-cause death (HR: 1.79, 95% CI: 1.12-2.85). The associations were independent of the atherosclerotic cardiovascular disease risk score. Further, the C-statistics increased 0.010 (P < 0.001), 0.013 (P < 0.001) and 0.016 (P < 0.001) separately when adding baPWV, adding the combination of baPWV and CIMT, and adding the VAg phenotypes to a model of conventional risk factors in predicting cardiovascular events.

Conclusion: This is the first study to evaluate the clinical implications of VAg phenotypes using multicentric data and undergone external validation in China. Our results emphasized that the classification of VAg phenotypes may be a potential tool to identify individuals who were susceptible to or resilient to VAg.

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中国人群血管老化表型与不良临床结果的关联：一项多中心研究。

目的：本研究旨在探讨基于实足年龄（CA）和血管年龄（VA）差异的血管老化（VAg）表型的临床意义。患者和方法：在一个多中心、横断面队列（n=15580）中，我们将VA定义为多变量线性回归模型中的预测年龄，该模型包括动脉的结构和功能参数以及传统的危险因素。根据Δ-age （CA - VA）的第10和第90百分位，我们将VAg的状态分为3种表型：早期VAg (EVA)，正常VAg和超正常VAg （SUPERNOVA）。在一个独立的前瞻性队列（n=5316）中，我们使用Cox生存分析来研究VAg表型与不良临床结局（包括全因死亡和心血管疾病）风险之间的关系。结果：在前瞻性队列（11.07年，927例事件）中，与正常VAg表型相比，EVA的风险增加(HR: 2.43；95% CI: 1.80-3.27)和SUPERNOVA的风险降低(HR: 0.75；95% CI: 0.64-0.90)的不良临床结果，特别是卒中事件。EVA还显示心肌梗死（HR: 3.21, 95% CI: 1.56-6.62）和全因死亡（HR: 1.79, 95% CI: 1.12-2.85）的风险较高。这种关联与动脉粥样硬化性心血管疾病风险评分无关。此外，当加入baPWV、baPWV与CIMT联合使用以及将VAg表型加入到预测心血管事件的常规危险因素模型时，c -统计量分别增加0.010 （P < 0.001）、0.013 （P < 0.001）和0.016 （P < 0.001）。结论：这是第一个使用多中心数据评估VAg表型临床意义的研究，并在中国进行了外部验证。我们的研究结果强调，对VAg表型的分类可能是一种潜在的工具，可以识别对VAg易感或有弹性的个体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.80

自引率

2.80%

发文量

193

审稿时长

6-12 weeks

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.