Association of Baseline Cardio-Ankle Vascular Index with 12-month Change in Arterial Stiffness in Patients with Coronary Artery Disease: An Exploratory Single-Center Longitudinal Analysis

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Stable coronary artery disease (n=157). Intervention: Baseline CAVI-mean ≥9.0 vs. Baseline CAVI-mean <9.0. Primary outcome: Non-worsening of CAVI-mean at 12 months (ΔCAVI-mean < +0.5) (Adjusted OR 8.10, 95% CI 3.35-19.58, p=<0.001).

Q: What does this research mean for the field?

A baseline cardio-ankle vascular index (CAVI-mean) ≥9.0 is associated with significantly higher odds of CAVI non-worsening at 12 months in patients with coronary artery disease, a pattern largely driven by regression to the mean. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the longitudinal change in arterial stiffness over 12 months using the cardio-ankle vascular index (CAVI) and its association with baseline characteristics in patients with coronary artery disease.

Pham Truong Son; Le Van Dung; Pham Nguyen Son; Nguyen Thi Kieu Ly; Dinh Cong Pho

doi:10.2147/vhrm.s623600

November 1, 2026Vascular Health and Risk ManagementOpen Access

Association of Baseline Cardio-Ankle Vascular Index with 12-month Change in Arterial Stiffness in Patients with Coronary Artery Disease: An Exploratory Single-Center Longitudinal Analysis

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Key result

Baseline CAVI ≥9.0 is linked to ~8.1-fold higher odds of 12-month non-worsening, driven by regression to the mean.

Adjusted OR 8.10
95% CI 3.35-19.58
P<0.001
n=157

Why the study?

Is a baseline CAVI-mean ≥9.0 associated with 12-month non-worsening of arterial stiffness beyond what is expected from regression to the mean in patients with stable coronary artery disease?

Key Points

To evaluate the longitudinal change in arterial stiffness over 12 months using the cardio-ankle vascular index (CAVI) and its association with baseline characteristics in patients with coronary artery disease.
Exploratory single-center longitudinal analysis of 157 patients with coronary artery disease followed for 12 months.
CAVI was measured bilaterally at baseline and 12 months; worsening was defined as a 12-month minus baseline mean CAVI (ΔCAVI-mean) ≥ +0.5.
Assessed correlations with clinical risk factors, carotid intima-media thickness, ankle-brachial index, and angiographic severity (SYNTAX and Gensini scores).
In the total cohort (n = 157), CAVI-mean showed no significant overall change from baseline to 12 months (9.20 ± 0.80 vs 9.15 ± 0.76; mean change −0.04, 95% CI −0.18 to 0.09; p = 0.51).
Worsening arterial stiffness occurred in 33 patients (21.0%) and did not occur in 124 patients (79.0%).
Worsening occurred in 9.3% (10 of 108) of patients with baseline CAVI-mean ≥9.0 compared with 46.9% (23 of 49) of those with baseline CAVI-mean <9.0 (p < 0.001).

Study Design

Type

Cohort (n=157)

Blinding

Blind angiographic scoring to vascular results

Multicenter

No

Structured PICO

Is a baseline CAVI-mean ≥9.0 associated with 12-month non-worsening of arterial stiffness beyond what is expected from regression to the mean in patients with stable coronary artery disease?

P

Population

157 clinically stable patients in Vietnam with angiographically documented coronary artery disease (≥50% stenosis), mean age 68.5 years (57.3% female), followed for 12 months with paired CAVI measurements.

E

Exposure

Baseline mean cardio-ankle vascular index (CAVI-mean) ≥9.0 (also analyzed continuously per 1-unit increase), measured via VaSera VS-1500N device

C

Comparator

Baseline CAVI-mean <9.0

O

Outcome

Non-worsening of CAVI-mean at 12 months (defined as 12-month minus baseline CAVI-mean [ΔCAVI-mean] < +0.5 units; worsening defined as ΔCAVI-mean ≥ +0.5 units)surrogate

Main Result

Odds Ratio: 8.1 (95% CI 3.35–19.58)

Absolute Event Rate: 90.7% vs 53.1%

p-value: p=<0.001

The apparent association between high baseline CAVI (≥9.0) and lower odds of 12-month arterial stiffness worsening in patients with stable CAD is explained by regression to the mean rather than a true biological effect, highlighting the need for repeated measurements and continuous modeling in longitudinal vascular stiffness studies.

Limitations

Post hoc secondary analysis from a single center with a small sample size (n=157) and only 33 worsening events.
Change in CAVI is mathematically coupled to baseline CAVI, and with only two measurements per patient, regression to the mean cannot be separated from true biological change.
Thresholds of 9.0 for baseline CAVI and 0.5 units for worsening are not clinically validated in patients with CAD.
Exclusion of patients with interim MACE or missing follow-up measurements restricts applicability to event-free survivors.
Follow-up data on blood pressure, lipid levels, medication changes, and adherence were not available.
Post hoc secondary analysis from a single center with 157 patients and only 33 worsening events, limiting statistical precision and multivariable adjustment.
Change in CAVI is mathematically coupled to baseline CAVI, and with only two measurements per patient, regression to the mean cannot be separated from true change.
The thresholds of 9.0 for baseline CAVI and 0.5 units for worsening are not validated in patients with CAD and no clinical outcomes were assessed.
Patients who had a major adverse cardiovascular event before 12 months or lacked a follow-up measurement were excluded.
Follow-up blood pressure, lipid levels, medication adjustments, and adherence were not available.

Implication

Baseline CAVI ≥9.0 should not inform expectations of non-worsening; leaves open the need for repeated measures and continuous modeling to address regression to the mean.

Abstract

The cardio-ankle vascular index (CAVI) reflects arterial stiffness and is associated with the severity of coronary artery disease (CAD).

Discussion

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Cite This Study

Son et al. (2026) conducted a cohort in Stable coronary artery disease (n=157). Baseline CAVI-mean ≥9.0 vs. Baseline CAVI-mean <9.0 was evaluated on Non-worsening of CAVI-mean at 12 months (ΔCAVI-mean < +0.5) (Adjusted OR 8.10, 95% CI 3.35-19.58, p=<0.001).

synapsesocial.com/papers/6ae866e7b29eedd18672876f https://doi.org/10.2147/vhrm.s623600

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Association of Baseline Cardio-Ankle Vascular Index with 12-month Change in Arterial Stiffness in Patients with Coronary Artery Disease: An Exploratory Single-Center Longitudinal Analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association of Baseline Cardio-Ankle Vascular Index with 12-month Change in Arterial Stiffness in Patients with Coronary Artery Disease: An Exploratory Single-Center Longitudinal Analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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