Association Between Cardio-Ankle Vascular Index and Heart Failure Outcomes: Insights From a Prospective Multicenter...

Area of Science:

• Cardiovascular Medicine
• Preventive Cardiology
• Biomarker Research

Background:

• Heart failure (HF) poses a significant public health challenge with poor prognosis.
• Arterial stiffness, a contributor to HF, is assessed by the cardio-ankle vascular index (CAVI).
• The prognostic value of CAVI in HF patients requires further clarification.

Purpose of the Study:

• To determine if CAVI independently predicts HF-related hospitalizations.
• To assess if CAVI adds prognostic value beyond established cardiovascular risk factors.

Main Methods:

• A sub-analysis of the prospective CAVI-J study included 2,932 Japanese adults (40-74 years) with cardiovascular risk factors.
• Participants were stratified by CAVI tertiles and followed for a median of 4.9 years.
• Cox proportional hazards models and reclassification indices evaluated risk and incremental prognostic value for HF hospitalization and cardiovascular death.

Main Results:

• High CAVI (≥9.0) was independently associated with a 3.18-fold increased risk of primary outcomes (P=0.034).
• Adding CAVI to conventional risk models significantly improved risk prediction (global chi-squared increase from 8.82 to 18.77, P=0.002).
• The net reclassification index was 0.621 (P<0.001), indicating improved prediction accuracy.

Conclusions:

• Elevated CAVI is an independent predictor of HF hospitalizations and cardiovascular death.
• CAVI modestly enhances risk prediction beyond conventional factors in individuals with cardiovascular risk factors.
• Further research is needed to fully establish the clinical utility of CAVI in HF risk stratification.