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Predictive Value of the Cardio‐Ankle Vascular Index for Cardiovascular Events in Patients at Cardiovascular Risk

2021; Wiley; Volume: 10; Issue: 16 Linguagem: Inglês

10.1161/jaha.120.020103

2047-9980

Toru Miyoshi, Hiroshi Ito, Kohji Shirai, Shigeo Horinaka, Jitsuo Higaki, Shigeo Yamamura, Atsuhito Saiki, M Takahashi, Mitsuru Masaki, Takafumi Okura, Kazuhiko Kotani, Takuro Kubozono, Ryo Yoshioka, Hajime Kihara, Koji Hasegawa, Noriko Satoh‐Asahara, Hajime Orimo, Yuichi Akasaki, Noriko Asahara, Masayuki Doi, Tomikazu Fukuoka, Hiromichi Fukushima, Yuji Hara, Koji Hasegawa, Keiichi Hirano, Takashi Hitsumoto, Toshio Honda, Shigeo Horinaka, Kotaro Ichinari, Toshihiko Ishimitsu, Kimihiko Ishimura, Mai Iwataki, Hiroshi Kaieda, Masahito Kajiya, Shigeshi Kamikawa, Hitoshi Kaneko, Hideo Kawakami, Hajime Kihara, Yūko Kikuchi, Hajime Kiyokawa, Takashi Kobayashi, Wataru Koguchi, Mitsuteru Koizumi, Takuro Kubozono, Motofumi Maguchi, Hitoshi Minowa, Michiaki Miyamoto, Akihito Miyoshi, Ken‐ichi Miyoshi, Toru Miyoshi, Maki Murata, Mitsunobu Murata, Tomoaki Nagao, Kazufumi Nakamura, Keigo Nakamura, Michitsugu Nakamura, Nobuyuki Nakano, Seiji Nanba, Kazuhisa Nishimura, Hachiro Obata, K Ogurusu, Takefumi Oka, Takafumi Okura, Madoka Onimaru, Shiro Ono, Go Onoue, Atsuhito Saiki, Satoru Sakuragi, Toshihiro Sarashina, Koichi Seta, Yoshimasa Shibata, Kazuhiro Shimizu, Kohji Shirai, Hiroyasu Sugiyama, Takumi Sumimoto, Sho Takahashi, Hitoshi Takehana, Hiroshi Takeshima, Masakatsu Todoroki, Youkou Tominaga, Tadao Uraoka, Hiroshi Yagi, Kensei Yahata, Ryo Yoshioka, Masanobu Takata, Kuniaki Otsuka, Shinichi Oikawa, Shigeo Yamamura,

Peripheral Artery Disease Management

Background Arterial stiffness is an important predictor of cardiovascular events; however, indexes for measuring arterial stiffness have not been widely incorporated into routine clinical practice. This study aimed to determine whether the cardio-ankle vascular index (CAVI), based on the blood pressure-independent stiffness parameter β and reflecting arterial stiffness from the origin of the ascending aorta, is a good predictor of cardiovascular events in patients with cardiovascular disease risk factors in a large prospective cohort. Methods and Results This multicenter prospective cohort study, commencing in May 2013, with a 5-year follow-up period, included patients (aged 40‒74 years) with cardiovascular disease risks. The primary outcome was the composite of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. Among 2932 included patients, 2001 (68.3%) were men; the mean (SD) age at diagnosis was 63 (8) years. During the median follow-up of 4.9 years, 82 participants experienced primary outcomes. The CAVI predicted the primary outcome (hazard ratio, 1.38; 95% CI, 1.16‒1.65; P<0.001). In terms of event subtypes, the CAVI was associated with cardiovascular death and stroke but not with myocardial infarction. When the CAVI was incorporated into a model with known cardiovascular disease risks for predicting cardiovascular events, the global χ2 value increased from 33.8 to 45.2 (P<0.001), and the net reclassification index was 0.254 (P=0.024). Conclusions This large cohort study demonstrated that the CAVI predicted cardiovascular events. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01859897.