Abstract 507: Change in Pulse Wave Velocity and Short Term Development of Cardiovascular Events in the Hemodialysis Population

Objectives: It has previously been demonstrated that single elevated measurements of carotid-femoral pulse wave velocity (CFPWV) among end-stage renal disease (ESRD) patients are associated with an increased risk of cardiovascular (CV) events. However, the association between single measurements of CFPWV and CV events was mostly driven by the high incidence of late events beyond 12 months of follow-up. The present prospective study aims to compare single measurements of CFPWV vs. the 2-year change in CFPWV (delta CFPWV) and their association with short-term development of CV events through 12 months in hemodialysis patients. Methods: Patients on hemodialysis were enrolled for a first measurement of CFPWV (CFPWV t=0 ) followed by a second measurement (CFPWV t=1 ) 2 years ± 1 month later. Patients were then followed up for an additional 12 months for the development of CV events (CV death, acute coronary syndrome, acute ischemic peripheral event necessitating intervention, or stroke). Results: Both CFPWV t=0 and CFPWV t=1 were measured for a total of 66 hemodialysis patients. During the 12-month follow-up period, 13 patients developed a total of 15 events, almost half (7/15) of which were fatal, 4/15 attributed to acute coronary syndrome (ACS), and 4/15 attributed to acute ischemic peripheral artery disease (PAD) necessitating intervention. No stroke events were recorded over the 12-month follow-up duration. Delta CFPWV (CFPWV t=1 - CFPWV t=0 ) was significantly associated with the development of CV events through 12 months with and without adjustment for CV risk factors, including blood pressure parameters (unadjusted: HR=1.22; p=0.001 vs. adjusted: HR=1.14; p=0.002). When delta CFPWV was substituted for either CFPWV t=0 or CFPWV t=1 in both the unadjusted and adjusted Cox regression models, neither measurement was associated with the development of new CV events. Conclusions: The change in CFPWV, but not single measurements of CFPWV, was significantly associated with the short-term development of CV events through 12 months.