January 1, 2008Circulation Journal150 citationsOpen Access

Relationship of Cardio-Ankle Vascular Index (CAVI) to Carotid and Coronary Arteriosclerosis

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Suspected coronary artery disease (n=443). Intervention: Cardio-Ankle Vascular Index (CAVI) vs. Brachial-ankle pulse wave velocity (baPWV). Primary outcome: Presence of multivessel coronary artery disease (p=0.0342).

MIMasayasu Izuhara KSKeisuke Shioji SKShin Kadota

Key Result

High Cardio-Ankle Vascular Index (CAVI) was independently associated with the presence of multivessel coronary disease (p=0.0342) and carotid intima-media thickness (p=0.0427), whereas brachial-ankle pulse wave velocity was not.

Study Design

Type

Cross-Sectional (n=443)

Multicenter

PICO

Population

443 patients with suspected coronary artery disease who underwent CAVI, carotid ultrasonography, and coronary angiography to evaluate the relationship between arterial stiffness and arteriosclerosis.

Exposure / Comparator

Cardio-Ankle Vascular Index (CAVI) vs Brachial-ankle pulse wave velocity (baPWV)

Primary Outcome

Presence of multivessel coronary artery disease, p=0.0342

Main Result

p-value: p=0.0342

Limitations

Cross-sectional design cannot determine whether high CAVI values prospectively predict vascular events and mortality.
CAVI cannot be accurately measured in patients with an ankle-brachial index (ABI) <0.90.
Patients with systolic dysfunction, atrial fibrillation, aortic disease, or valvular heart disease were excluded, limiting generalizability.
Blood pressure was measured using an upper arm cuff, which may not exactly reflect central aortic stiffness.

Abstract

BACKGROUND: The cardio-ankle vascular index (CAVI) has been recently reported as a new index of aortic stiffness, which is less influenced by blood pressure than pulse wave velocity (PWV). The present study investigated the relationship between the levels of CAVI and carotid and coronary arteriosclerosis. METHODS AND RESULTS: The 443 consecutive patients who underwent CAVI, carotid sonography, and coronary angiography in hospital were examined. Intima-media thickness (IMT) and carotid plaque were evaluated by ultrasonography. The severity of coronary artery disease (CAD) was evaluated by coronary angiography and the subjects were divided into 4 groups (0, no significant organic stenosis: 1, 1-vessel disease: 2, 2-vessel disease: 3, 3-vessel disease). Univariate analyses showed that both CAVI and brachial-ankle PWV (baPWV) were associated with IMT and the presence of carotid plaque. Multiple stepwise regression analyses revealed that CAVI (p=0.0427), but not baPWV, was associated with the IMT. Both CAVI (p<0.0001) and baPWV (p=0.0140) were significantly associated with the severity of CAD. Multiple logistic analyses revealed that CAVI (p=0.0342), but not baPWV (p=0.8027), was associated with the presence of multivessel disease. CONCLUSION: High CAVI implies progression of carotid and coronary arteriosclerosis. CAVI may be more closely linked with arteriosclerosis than baPWV.

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Cite This Study

Izuhara et al. (Tue,) conducted a cross-sectional in Suspected coronary artery disease (n=443). Cardio-Ankle Vascular Index (CAVI) vs. Brachial-ankle pulse wave velocity (baPWV) was evaluated on Presence of multivessel coronary artery disease (p=0.0342). High Cardio-Ankle Vascular Index (CAVI) was independently associated with the presence of multivessel coronary disease (p=0.0342) and carotid intima-media thickness (p=0.0427), whereas brachial-ankle pulse wave velocity was not.

synapsesocial.com/papers/6a71b74e31a3df824329c643 https://doi.org/https://doi.org/10.1253/circj.cj-08-0152