Key result
Pathological arterial stiffness (CAVI ≥9.0) before CABG was associated with a higher 10-year rate of the combined adverse endpoint compared to normal CAVI (59.46% vs 46.63%; p=0.03).
Why the study?
The study was conducted to determine the effect of arterial stiffness and multifocal atherosclerosis on the 10-year prognosis of patients after coronary artery bypass grafting.
Does pathological arterial stiffness (CAVI ≥9.0) and multifocal atherosclerosis predict worse 10-year clinical outcomes in patients undergoing CABG?
Cohort (n=274)
Does pathological arterial stiffness (CAVI ≥9.0) and multifocal atherosclerosis predict worse 10-year clinical outcomes in patients undergoing CABG?
Absolute Event Rate: 59.46% vs 46.63%
p-value: p=0.03
Pathological arterial stiffness (CAVI ≥9.0) and multifocal atherosclerosis are independent predictors of adverse long-term outcomes and mortality in patients undergoing CABG.
Elevated CAVI and multifocal atherosclerosis may predict worse 10-year post-CABG outcomes; hypothesis-generating and requires prospective validation before guiding practice.
The aim of the study was to study the effect of arterial stiffness and multifocal atherosclerosis on the 10-year prognosis of patients after coronary artery bypass grafting. Methods. Patients with coronary artery disease (n = 274) who underwent coronary artery bypass grafting (CABG), in whom cardio-ankle vascular index (CAVI) was assessed using the VaSera VS-1000 device and the presence of peripheral atherosclerosis in Doppler ultrasound. Groups were distinguished with normal CAVI (<9.0, n = 163) and pathological CAVI (≥9.0, n = 111). To assess the prognosis, coronary and non-coronary death, myocardial infarction, acute cerebrovascular accident/transient ischemic attack, repeated CABG, percutaneous coronary intervention, carotid endarterectomy, peripheral arterial surgery, pacemaker implantation were analyzed. Results. During the observation period, mortality was 27.7%. A fatal outcome from all causes was in 37 (22.7%) patients in the group with normal CAVI and in 39 (35.14%) in the group with pathological CAVI (p = 0.023). Death from cardiac causes was more common in the group with CAVI ≥ 9.0—in 25 cases (22.52%) than in the group with CAVI < 9.0—in 19 (11.6%, p = 0.016). The combined endpoint in patients with pathological CAVI was detected in 66 (59.46%) cases, with normal CAVI values—in 76 (46.63%) cases (p = 0.03). The presence of diabetes mellitus, multifocal atherosclerosis (p = 0.004), pathological CAVI (p = 0.063), and male gender were independent predictors of death at 10-year follow-up after CABG. The presence of multifocal atherosclerosis and pathological CAVI during the preoperative examination of patients were independent predictors of the combined endpoint development. Findings. Patients with coronary artery disease with pathological CAVI before CABG were more likely to experience adverse events and death in the long-term follow-up than patients with normal CAVI. Further studies are needed to investigate the possibility of correcting pathological CAVI after CABG after secondary prevention and the possible impact of this correction on prognosis.
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Сумин et al. (2022) conducted a cohort in coronary artery disease (n=274). Pathological cardio-ankle vascular index (CAVI ≥9.0) vs. Normal CAVI (<9.0) was evaluated on Combined endpoint of death, myocardial infarction, stroke/TIA, and cardiovascular procedures (p=0.03). Pathological arterial stiffness (CAVI ≥9.0) before CABG was associated with a higher 10-year rate of the combined adverse endpoint compared to normal CAVI (59.46% vs 46.63%; p=0.03).
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