Aims: The aim was to assess if arterial stiffness, indexed as aortic pulse wave velocity (PWV), is a viable CVD risk prediction variable in high cardiometabolic risk population.

Methods and results: We studied 4259 high-risk patients (36.2% male), on average having 3,49±1,05 metabolic syndrome components(18% having 5), as per NCEP ATPIII criteria. Starting from 2007, patients were observed and investigated in a single specialized cardiology center. The outcome follow-up was performed using national death registry and national healthcare fund database. CVD events during the follow-up included fatal or non-fatal myocardial infarction (MI) or stroke. Mean age of the study population was 54,13±6,23 with no significant difference between the event free group(EFG) vs. the event group(EG) with at least one CVD event(n= 129) during the follow-up, which was 1389,3±625,73 days. Comparing the two groups, aortic PWV was 8,8±1,6(EFG) vs. 9,41±2(EG), p<0.001, mean aortic pulse pressure(Ao_PP)43,28±11,02(EFG) vs. 46,25±12,32(EG), p=0.003, mean aortic blood pressure(MeanBP_Ao) 106,69±12,45(EFG) vs. 111,07±16,6(EG), p<0.001.

In logistic regression model, aortic PWV remained a strong independent CVD event predictor. Odds ratio (OR) for CV event is 1.387(95% CI 1,182; 1,627, p<0,001). Comparing cumulative proportion survival rate between the 3rd vs. 1st tertile(PWV <8m/s vs. PWV >=9.3m/s) of aortic PWV the OR for CVD event was 1,748 (95% CI 1,135; 2,691, p=0,011).

Conclusion: Aortic PWV remained a strong CVD event predictor in univariate as well as multivariate stepwise logistic regression models. Survival analysis confirmed it as a viable CVD prediction indicator, to be considered including it into widely used CVD risk assessment tools, especially for high CVD risk group.