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. 2022 Oct 25;9(11):368.
doi: 10.3390/jcdd9110368.

Cardio-Ankle Vascular Index as an Arterial Stiffness Marker Improves the Prediction of Cardiovascular Events in Patients without Cardiovascular Diseases

Yuko Okamoto  1   2 , Toru Miyoshi  1 , Keishi Ichikawa  1 , Yoichi Takaya  1 , Kazufumi Nakamura  1 , Hiroshi Ito  1
Affiliations

Cardio-Ankle Vascular Index as an Arterial Stiffness Marker Improves the Prediction of Cardiovascular Events in Patients without Cardiovascular Diseases

Yuko Okamoto et al. J Cardiovasc Dev Dis. .

Abstract

Several studies have reported that the cardio-ankle vascular index (CAVI), a non-invasive measurement of arterial stiffness, is associated with the incidence of cardiovascular events. We investigated whether adding CAVI to a risk score improves the prediction of cardiovascular events in the setting of primary prevention. This retrospective observational study included consecutive 554 outpatients with cardiovascular disease risk factors but without known cardiovascular disease (68 ± 9 years, 64% men). The CAVI was measured using the VaSera vascular screening system. Major adverse cardiovascular events (MACE) included cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, and coronary revascularization. During a median follow-up of 4.3 years, cardiovascular events occurred in 65 patients (11.7%). Multivariate Cox analysis showed that abnormal CAVI (>9.0) was significantly associated with the incidence of MACE (hazard ratio 2.31, 95% confidence interval 1.27−4.18). The addition of CAVI to the Suita score, a conventional risk score for coronary heart disease in Japan, significantly improved the C statics from 0.642 to 0.713 (p = 0.04). In addition to a conventional risk score, CAVI improved the prediction of cardiovascular events in patients with cardiovascular disease risk factors but without known cardiovascular diseases.

Keywords: arterial stiffness; cardio-ankle vascular index; cardiovascular events; risk factors.

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Conflict of interest statement

T.M. revived the honorarium from Fukuda Denshi Inc. The authors declare no conflict of interest associated with this manuscript.

Figures

Figure 1
Figure 1
Kaplan–Meier plot of cumulative probability of cardiovascular events by cardio-ankle vascular index (CAVI) levels. Time to cardiovascular events, including cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, heart failure requiring hospitalization, and coronary revascularization, according to baseline CAVI. The cumulative incidence rates of cardiovascular events according to CAVI levels were significantly higher in the abnormal group (CAVI > 9.0) than in the normal (CAVI < 8) and abnormal groups (8 < CAVI ≤ 9) (p-value for trend < 0.01).
Figure 2
Figure 2
Correlation between CAVI and the Suita score. Scatter plot showing the correlation between CAVI and the Suita score (A) and CAVI according to the risk category of the Suita score (B).
Figure 3
Figure 3
Comparison of the receiver-operating characteristic (ROC) curves. Black curve: predictive ability based on the Suita score. Blue curve: predictive ability based on the Suita score and CAVI. CI: confidence interval.
See this image and copyright information in PMC

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