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Observational Study
. 2021 Jul 1;28(7):766-775.
doi: 10.5551/jat.58727. Epub 2020 Sep 25.

Cardio-Ankle Vascular Index Predicts Post-Discharge Stroke in Patients with Heart Failure

Yu Sato  1 , Akiomi Yoshihisa  1   2 , Yasuhiro Ichijo  1 , Koichiro Watanabe  1 , Yu Hotsuki  1 , Yusuke Kimishima  1 , Tetsuro Yokokawa  1 , Tomofumi Misaka  1   2 , Takamasa Sato  1 , Takashi Kaneshiro  1 , Masayoshi Oikawa  1 , Atsushi Kobayashi  1 , Yasuchika Takeishi  1
Affiliations
Observational Study

Cardio-Ankle Vascular Index Predicts Post-Discharge Stroke in Patients with Heart Failure

Yu Sato et al. J Atheroscler Thromb. .

Abstract

Aim: We aimed to evaluate the significance of the cardio-ankle vascular index (CAVI) to predict stroke in patients with heart failure (HF).

Methods: This was a prospective observational study, which recruited clinical data from a total of 557 patients who had been hospitalized for HF and undergone CAVI. According to the receiver operating characteristic curve analysis, the accurate cut-off value of CAVI in predicting post-discharge stroke was 9.64. We divided the patients into two groups: the high-CAVI group (HF patients with CAVI ≥ 9.64, n=111, 19.9%) and the low-CAVI group (HF patients with CAVI ＜9.64, n=446, 80.1%). We compared the patients' characteristics and post-discharge prognosis. The primary endpoint was stroke.

Results: The high-CAVI group was older (73.0 vs. 65.5 years old, P＜0.001). Male sex (73.9% vs. 61.4%, P=0.015), coronary artery disease (47.7% vs. 36.1%, P=0.024), and diabetes mellitus (54.1% vs. 37.4%, P=0.001) were more prevalent in the high-CAVI group. In contrast, there was no difference in left ventricular ejection fraction, and prevalence of hypertension and dyslipidemia. The Kaplan-Meier analysis demonstrated that post-discharge stroke rate was higher in the high-CAVI group than in the low-CAVI group (log-rank P=0.005). In multivariate Cox proportional hazard analysis, high CAVI was found to be an independent predictor of stroke, with an adjusted hazard ratio of 3.599, compared to low CAVI.

Conclusion: CAVI independently predicts stroke in patients with HF.

Keywords: Arterial stiffness; Atherosclerosis; Cardio-ankle vascular index; Heart failure; Stroke.

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Figures

Fig.1. Patient flowchart
Fig.1. Patient flowchart
CAVI, cardio-ankle vascular index.
Fig.2. Kaplan-Meier analysis for occurrence of post-discharge stroke
Fig.2. Kaplan-Meier analysis for occurrence of post-discharge stroke
CAVI, cardio-ankle vascular index.
See this image and copyright information in PMC

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