3.7 PULSE WAVE VELOCITY IS AN INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR EVENTS, MORTALITY AND DECLINE IN RENAL FUNCTION IN PATIENTS WITH TYPE 1 DIABETES

Purpose: The prognostic significance of carotid-femoral pulse wave velocity (cfPWV) remains to be determined in patients with type 1 diabetes (T1D). We investigated the predictive value of cfPWV for various endpoints in T1D. Methods: At baseline, cfPWV was measured using the SphygmoCor device in 652 patients with T1D and various degrees of albuminuria. Endpoints were traced through National Registers and patient records and comprised: composite CVE, mortality, progression in albuminuria, and decline in estimated glomerular filtration rate (eGFR) ≥30%. Median follow-up ranged from 5.2 to 6.2 years. Slope estimates of eGFR and urinary albumin creatinine rate (UACR) were calculated for a median of 5.5 years. Adjustment included sex, age, mean arterial pressure, LDL cholesterol, smoking, HbA1c, UACR and eGFR at baseline. Hazard ratios (HR) were calculated per 1 standard derivation (SD) increase in cfPWV. Results: Of the 652 participants (56% male); mean±SD age was 54 ± 13 years and cfPWV 10.5 ± 3.38 m/s2. After adjustment, higher cfPWV was significantly associated with all endpoints: composite CVE (n = 81; HR:1.31; p = 0.045); mortality (n = 48; HR:1.39; p = 0.033); progression in albuminuria (n = 31; HR:1.16; p = 0.012); and decline in eGFR ≥ 30% (n = 90; HR: 1.39; p = 0.015).Higher cfPWV was associated with a steeper decline in eGFR and a steeper increase in UACR after adjustments (p ≤ 0.009). Conclusions: In patients with T1D, higher arterial stiffness was consistently associated with a higher risk of CVE, mortality and decline in renal function, independent of other risk factors. Measurement of cfPWV may have a promising role in risk stratification in T1D.