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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Cardio-Ankle Vascular Index is Independently Associated with Future Cardiovascular Events in Outpatients with
Yuta Sato1, Daiji Nagayama, Atsuhito Saiki
1Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center.
Insights
Cardio-ankle vascular index (CAVI) predicts future cardiovascular events in individuals with metabolic disorders. Higher CAVI indicates increased risk, suggesting its use for identifying patients needing intensive treatment.
Area of Science:
- Cardiology
- Vascular Medicine
- Metabolic Disorders
Background:
- Arterial stiffness is a significant risk factor for cardiovascular events.
- Metabolic disorders, including diabetes, hypertension, and dyslipidemia, are prevalent and increase cardiovascular risk.
- Early identification of individuals at high risk within this population is crucial for timely intervention.
Purpose of the Study:
- To determine if cardio-ankle vascular index (CAVI), a marker of arterial stiffness, independently predicts future cardiovascular events.
- To assess the utility of CAVI in identifying individuals with metabolic disorders who are at higher risk of cardiovascular events.
Main Methods:
- Prospective study of 1080 outpatients with metabolic disorders (diabetes, hypertension, dyslipidemia) screened for cardiovascular events, low ankle-brachial index, and atrial fibrillation.
- Cardio-ankle vascular index (CAVI) was measured at baseline between April 2004 and March 2006.
- Subjects were followed for a median of 6.7 years, with new-onset myocardial infarction or angina pectoris as primary endpoints.
Main Results:
- A total of 1003 subjects were analyzed.
- Higher baseline CAVI quartiles were associated with increased age, male ratio, and future cardiovascular events.
- Independent predictors of future cardiovascular events included increased CAVI (HR 1.126), male gender, smoking, diabetes mellitus, and hypertension.
Conclusions:
- Cardio-ankle vascular index (CAVI) is an independent predictor of future cardiovascular events in individuals with metabolic disorders.
- CAVI can help identify high-risk individuals who may benefit from more intensive therapeutic strategies.
- This marker provides valuable prognostic information beyond traditional risk factors.
Aim:
We investigated whether cardio-ankle vascular index (CAVI), an arterial stiffness marker, independently predicts future cardiovascular events in subjects with metabolic disorders.
Methods:
1562 outpatients underwent CAVI between April 2004 and March 2006 at Toho University, Sakura Medical Center in Chiba, Japan. Patients who already had cardiovascular events at baseline, patients with low ankle brachial index (＜0.9), and patients with atrial fibrillation were excluded. After exclusion, 1080 subjects with metabolic disorders including diabetes mellitus, hypertension and dyslipidemia were screened and followed prospectively.
Results:
Eventually, 1003 subjects (92.9% of 1,080 subjects) followed until March 2012 (follow-up duration 6.7±1.6 years) were analyzed. During the observation period, 90 subjects had new-onset myocardial infarction or angina pectoris confirmed by angiography. All subjects were stratified into quartiles by baseline CAVI (Q1: CAVI ≤8.27, Q2: CAVI 8.28-9.19, Q3: CAVI 9.20-10.08, Q4: CAVI ≥10.09). Age, male ratio and future cardiovascular events increased as CAVI quartile became higher. In Cox proportional hazards regression analysis, the factors independently associated with higher risk of future cardiovascular events were every 1.0 increment of CAVI [hazard ratio (HR) 1.126, p= 0.039], male gender (HR 2.276, p=0.001), smoking (HR 1.846, p=0.007), diabetes mellitus (HR 1.702,p=0.020), and hypertension (HR 1.682, p=0.023).
Conclusion:
In individuals with metabolic disorders, CAVI was a predictor of future cardiovascular events, independent of traditional coronary risk factors. CAVI is a potentially valuable tool to identify persons likely to benefit from more intensive therapeutic approaches.
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