Key result
Abnormal preoperative CAVI affects ~47% of knees and correlates with older age and lower BMI.
Why the study?
Cardiovascular disease is a major risk factor for mortality in osteoarthritis patients undergoing total knee arthroplasty, but preoperative arteriosclerosis had not been evaluated using the cardio-ankle vascular index.
Cross-Sectional (n=209)
No
Nearly half of patients undergoing total knee arthroplasty have abnormal preoperative arteriosclerosis as measured by CAVI, which correlates significantly with older age and lower BMI.
Answers are grounded in this paper and cite their sources.
CAVI-detected arteriosclerosis is prevalent before TKA and associated with age and BMI; leaves open whether screening improves perioperative risk stratification.
Purpose: Cardiovascular disease (CVD) is a major risk factor for mortality in patients with osteoarthritis, and comorbidities increase postoperative complications after total knee arthroplasty (TKA). Arteriosclerosis plays a main role in hemodynamic dysfunction and CVD; however, arteriosclerosis has not been preoperatively evaluated before TKA using the cardio-ankle vascular index (CAVI). In this study, we evaluated the degree of preoperative arteriosclerosis using the CAVI in patients undergoing TKA, as well as its correlations with several preoperative patient factors. Methods: Arteriosclerosis was evaluated in 209 consecutive patients (251 knees) with osteoarthritis who underwent TKA at our institution between May 2011 and June 2022. The CAVI was measured in the supine position 1 day before TKA, and the correlations between the CAVI and several clinical factors were analyzed. Results: The CAVI was normal in 62 knees (25%), borderline in 71 knees (28%), and abnormal in 118 knees (47%). Univariate analysis revealed a moderate positive correlation between preoperative CAVI and age (r = 0.451, p < 0.001) and a weak negative correlation between preoperative CAVI and body weight (r = −0.306, p < 0.001) and body mass index (BMI) (r = −0.319, p < 0.001). Multivariate analysis showed that age (β = 0.349, p < 0.001) and BMI (β = −0.235, p < 0.001) were significantly correlated with preoperative CAVI. Conclusion: Arteriosclerosis should be carefully managed intraoperatively and postoperatively in patients with osteoarthritis undergoing TKA, particularly in older patients and patients with a low BMI.
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Ishii et al. (2023) conducted a cross-sectional in Osteoarthritis (n=209). Patient factors (age and BMI) was evaluated on Correlation between preoperative cardio-ankle vascular index (CAVI) and clinical factors (β = 0.349 for age; β = -0.235 for BMI, p=<0.001). Preoperative arteriosclerosis evaluated by CAVI was abnormal in 47% of knees and correlated with older age and lower BMI.
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