Autonomic nervous system activity and decline as prognostic indicators of cardiovascular and cerebrovascular events: the 'PROOF' Study. Study design and population sample. Associations with sleep-related breathing disorders: the 'SYNAPSE' Study.
BACKGROUND
Transversal studies have underlined the association between the decline in autonomic nervous system (ANS) activity and all-cause mortality. However, the predictive value of ANS has never been prospectively assessed in a general population-based cohort.


METHODS
The PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events) cohort study was designed to prospectively assess the predictive value of ANS activity level in the general population, with regard to cardiovascular and cerebrovascular events, and death. This predictive power will be compared with the usual and newly discovered risk factors for the purposes of developing a risk model.


RESULTS
A prospective cohort of elderly subjects aged 65 years upon study entry were recruited from the electoral list of the city of Saint-Etienne, France. Three initial 2-year examination programs were scheduled for 7 years (2001-2007), followed by late events monitoring. At each examination, ANS activity was assessed along with clinical and biological cardiovascular risk factors, brain MRI, neuropsychological evaluation, physical activity profile, and sleep-related breathing disorders. The main study outcomes are stroke, myocardial infarction and death from any cause. A cohort consisting of 1,011 subjects aged 65.6 (0.8) years was constituted.


CONCLUSIONS
Despite other selective characteristics, the associations between ANS activity and events will be applicable to other populations.
Barthélémy
Jean-Claude
JC
Clinical and Exercise Physiology Laboratory, University Hospital, Saint-Etienne, France. JC.Barthelemy@univ-st-etienne.fr
Pichot
Vincent
V
Dauphinot
Virginie
V
Celle
Sébastien
S
Laurent
Bernard
B
Garcin
Arnauld
A
Maudoux
Delphine
D
Kerleroux
Judith
J
Lacour
Jean-René
JR
Kossovsky
Michel
M
Gaspoz
Jean-Michel
JM
Roche
Frédéric
F
D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015340:Epidemiologic Research Design; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology*