Vascular Age in Patients Admitted for Coronary Syndrome with ST Segment Elevation

Abstract

Background: Vascular age is an emerging health indicator and predictor of vital organ damage (heart, brain, and kidneys). Arterial stiffness is the most widely used measure for predicting vascular aging status. For a very long time, specific risk calculation algorithms were used for each cardiovascular disease, but they were not used to approximate vascular age and therefore to give an idea of the risk of all cardiovascular complications. A review of all epidemiological studies is therefore necessary to allow a global and multimodal evaluation of the different determinants of vascular age and the association of vascular aging with cardiovascular events. Methods and Results: We are conducting a retrospective descriptive and analytical study of 284 patients admitted to the cardiology department for ST elevation myocardial infarction (STEMI). The mean chronological age of our patients was 60,89 years, while the vascular age was much higher, up to 75 years. The vascular age of STEMI patients is 14 years higher than the chronological age. The definition of the early vascular age, normal Vascular age (VA) and Supernova profiles was based on the calculation of the difference between chronological age and vascular age, then the different clinical and paraclinical parameters of the 3 categories were studied allowing to conclude after a multivariate analysis that: diabetes (OR=9.25, [3.52; 24.36], p <0.0001) and smoking (OR=12.01, [4.56; 31.62], p<0.0001) were associated with higher rates of EVA, while hypertension (OR=1.35, [0.58; 3.1], p = 0.485) is a neutral factor. Also, age (OR=1.23, [1.11;1.38], p= 0.0002), age range between 40 and 54 years old (OR=42.53, [7.04; 256.82], p <0.0001) promotes the EVA phenotype while advanced age is a confounding factor. regarding gender, female (OR=0.35, [0.13; 0.96], p= 0.041) is a protective factor. From this analytical study we observe that there is a large difference between chronological and vascular age. This is due to the interaction between the different risk factors and each one potentiates the other. More the patient has risk factors, the more his vessels are sick and the more he risks having fatal events. And this has an impact on the overall management of the patient.