The effect of radial pulse spectrum on the risk of major adverse cardiovascular events in patients with type 2 diabetes

Abstract

Radial pulse spectrum has been shown to correlate with coronary stenosis in patients with type 2 diabetes mellitus (T2DM). In academia, it has not been demonstrated that the radial artery pulse spectrum is an independent risk factor for major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and all-cause mortality. The primary objective of this study is to assess the risk of MACE, in patients with T2DM and to determine if an increase in MACE would be associated with a first harmonic (C1) increase in the radial artery pulse. 1972 consecutive patients with T2DM were enrolled. All subjects received measurements of radial pulse waves at baseline. Harmonic analysis of radial pressure wave was performed. The hazard ratios for MACE and its 95% confident interval were estimated using Cox proportional hazard model. The follow-up period lasted for one year. MACE was detected in 232 (11.8%) of those with T2DM. The log-rank test demonstrated that the cumulative incidence of patients with C1 above 0.96 was greater than those with C1 bellow 0.96. Comparing the patients with C1 smaller than first quartile to the patients with C1 greater than third quartile, higher C1 increased the cardiovascular risks as follows: MACE (Hazard ratio,1.93; 95% CI,1.31–2.86), stroke (Hazard ratio, 1.61; 95% CI, 0.90–2.90), myocardial infarction (Hazard ratio, 2.23; 95% CI, 1.33–3.74). The risk for the composite MACE increased continuously as C1 increased (P < 0.001 for trend). The hazard ratio and trend for all-cause mortality were not significant. Increased C1 resulted in increased risk for nonfatal stroke, and nonfatal myocardial infarction among patients with T2DM. Our results indicate that the degree of C1 is a risk factor for nonfatal MACE. Therefore, the radial pulse spectrum could identify patients with T2DM at high risk of nonfatal MACE.