Fourth harmonic of radial pulse wave predicts adverse cardiac events in asymptomatic patients with type 2 diabetes.

Aims: Studies have shown that the fourth harmonic of the radial pulse wave (C4) is associated with atherosclerotic processes and myocardial ischemia. We sought to investigate whether C4 is an independent predictor of adverse cardiac events (ACE).

Methods: The baseline C4 is calculated using the Fourier series method. 1968 asymptomatic patients with type 2 diabetes were followed up for 1.8 ± 0.4 years and survival analysis were performed using Cox proportional hazard model.

Results: The Cox regression analysis showed that the C4 value is independent and inversely related to ACE both before and after adjusting for age, sex, smoke, systolic blood pressure, dyslipidemia, and Hba1c. (P for trend < 0.001) CONCLUSIONS: Decreasing C4 is associated with an increased risk of ACE in asymptomatic patients with type 2 diabetes.