DIFFERENCE BETWEEN CHRONOLOGICAL AND VASCULAR AGE AS A PREDICTOR FOR CARDIOVASCULAR EVENTS - IDENTIFICATION OF PATIENTS WITH SUPERNORMAL VASCULAR AGING (SUPERNOVA)

Abstract

Objective: Pulse wave velocity (PWV) is an established marker of early vascular aging (EVA), but may also help identifying individuals with supernormal vascular aging (SUPERNOVA). Aim of this study is to test the hypothesis that individuals with the largest difference between chronological and vascular age (Delta-age), calculated from classical CV risk factors and PWV, show the lowest rate of CV events, and may thus be defined SUPERNOVA. Design and method: Vascular age was calculated according to the best fitting model for chronological age prediction, in the cross-sectional Reference Values for Arterial stiffness Collaboration Database (n = 11,406), for different age categories. The risk of fatal and non-fatal CV events associated with Delta-age was investigated in the longitudinal Malmö Diet and Cancer Study cohort (n = 2642). Delta-age deciles were used to define EVA (<3.0 years), normal vascular ageing (VA, 3.0 to 8.8 years) and SUPERNOVA (>8.8 years). Results: In the Reference Values Database, the most significant predictor of vascular age (full model r2 = 0.598) was PWV. In the Malmö Diet and Cancer Study Cohort (6.6-year follow-up, 286 events). Delta-age was significantly and inversely associated with CV events. Compared to normal VA, SUPERNOVA had lower risk [HR 0.55 (95%CI 0.36–0.82)], whereas EVA had higher risk [HR 2.88 (95%CI 1.88–4.40)]. There was no significant association with all-cause mortality. Conclusions: PWV proved to be useful to identify SUPERNOVA individuals. Further characterization of this extreme phenotype may help discovering novel protective molecular pathways and providing preventive strategies for successful vascular aging.