Hypothesis
- CRTI is independently associated with a relatively higher prevalence of metabolic syndrome, arterial augmentation index and a more adverse cardiovascular risk profile (higher QRISK 3 scores, Hs-CRP) than that of the frequency-matched group of uninjured combat veterans exposed to the same conflict.
- This risk profile is modified with time from exposure such that the relative differences between the injured and uninjured will be greater at FU1 than at baseline.
Summary
Baseline analysis of the ADVANCE data generated three main original cardiovascular manuscripts. The reported data showed that CRTI was independently associated with increased prevalence of Metabolic syndrome, arterial stiffness using the rate-adjusted arterial augmentation index and lower subendocardial variability ratio (a surrogate marker of coronary blood flow). CRTI was also associated with increased vascular inflammation (CRP) and indirect measures of atherogenesis (AIP) and insulin resistance (estimated glucose disposal rate). Here we aim to examine the relationship between CRTI and cardiovascular risk markers including the diagnosis of metabolic syndrome, vascular inflammation (Hs-CRP), arterial stiffness (augmentation index) as well as the factors influencing this relationship (eg rank, relative obesity, diet and exercise). To examine how the exposure time has influenced this relationship baseline vs FU1). This will involve examining the comparative prevalence of Metabolic syndrome among the injured vs uninjured at FU and comparing the relative change for the two groups. A similar exercise will be performed for arterial augmentation index, QRISK 3 scores, subendocardial viability ratio and Hs-CRP. The influence of modifying factors such as age, rank and duration of follow-up will be examined using multivariable analyses.
Keywords
CRTI, metabolic syndrome, HS-CRP, Qrisk, Cardiovascular risk