Key result
High cardio-ankle vascular index (≥8) was associated with an increased risk of major adverse cardiovascular events compared to normal index (<8) in older adults with HIV (HR 2.11; 95% CI 1.06-4.20).
Why the study?
Increased arterial stiffness indicates CVD and death in the general population, but the prognostic utility of the cardio-ankle vascular index in older adults living with HIV remained to be investigated.
Does a high cardio-ankle vascular index (CAVI ≥8) predict major adverse cardiovascular events in older adults living with HIV?
Cohort (n=347)
Yes
Does a high cardio-ankle vascular index (CAVI ≥8) predict major adverse cardiovascular events in older adults living with HIV?
Hazard Ratio: 2.11 (95% CI 1.06–4.2)
p-value: p=0.033
May flag higher MACE risk in older adults with HIV; hypothesis-generating and should not yet change practice.
Increased arterial stiffness is an indicator of cardiovascular disease (CVD) and death in the general population. The cardio-ankle vascular index (CAVI) is a novel method for measuring arterial stiffness. This study investigated the utility of CAVI as a prognostic indicator of CVD and death in older adults living with HIV(OALHIV). Patients aged ≥50 taking antiretroviral treatment with no history of cardiovascular events enrolled from multiple centers in Chiang Mai, Thailand. Participants (N = 347) who underwent CAVI were followed up for five years. The primary endpoint was major adverse cardiovascular events (MACE): a composite of total deaths and hospitalizations due to myocardial infarction, coronary revascularization, stroke, and heart failure. Cox regression analysis determined between normal (<8) and high (≥8) CAVI against the incidence of MACE. Forty-five participants (13.0%) were diagnosed with MACE. The risk of MACE was more significant in high CAVI than normal CAVI (adjusted HR = 2.11, 95% confidence interval 1.06–4.20, p = 0.033). In OALHIV, CAVI was an independent prognosis of MACE, in addition to conventional CVD risk factors. CAVI-assisted to help identify high-risk patients showed the benefit of further evaluation and more intensive therapy to prevent CVD and death.
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Rerkasem et al. (2022) conducted a cohort in HIV (n=347). High cardio-ankle vascular index (CAVI ≥8) vs. Normal cardio-ankle vascular index (CAVI <8) was evaluated on major adverse cardiovascular events (MACE): a composite of total deaths and hospitalizations due to myocardial infarction, coronary revascularization, stroke, and heart failure (HR 2.11, 95% CI 1.06-4.20, p=0.033). High cardio-ankle vascular index (≥8) was associated with an increased risk of major adverse cardiovascular events compared to normal index (<8) in older adults with HIV (HR 2.11; 95% CI 1.06-4.20).
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