Improved Prediction of Cardiovascular Events Using Serial Cardio-Ankle Vascular Index (CAVI) Measurements: A 10-Year...

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Preventive Cardiology

Background:

• Cross-sectional studies limit understanding of long-term vascular changes using cardio-ankle vascular index (CAVI).
• Arterial stiffness assessment is crucial for cardiovascular risk prediction.
• Investigating serial CAVI measurements can offer deeper insights into vascular health dynamics.

Purpose of the Study:

• To determine if serial cardio-ankle vascular index (CAVI) measurements enhance cardiovascular (CV) event prediction beyond a single baseline value.
• To evaluate the predictive performance of longitudinal CAVI data in a prospective cohort.
• To assess the utility of serial CAVI in long-term CV risk stratification.

Main Methods:

• Prospective cohort study (Electricity Generating Authority of Thailand study) with 5-year follow-up intervals.
• Serial CAVI measurements analyzed as time-varying covariates in Cox proportional hazards models.
• Primary composite CV outcomes included coronary artery disease, stroke, or CV death, adjusted for conventional risk factors.

Main Results:

• Mean CAVI increased significantly over 10 years (p < 0.001) in 3913 participants.
• Serial CAVI independently predicted CV outcomes (HR 1.47; p=0.019), unlike baseline CAVI (HR 1.14; p=0.22).
• Models incorporating serial CAVI demonstrated superior predictive performance (ΔAIC=37.1; ΔBIC=32.7).

Conclusions:

• Longitudinal monitoring of cardio-ankle vascular index (CAVI) provides superior prediction of long-term cardiovascular events compared to a single measurement.
• Serial CAVI assessment can significantly improve cardiovascular risk stratification.
• Longitudinal CAVI monitoring supports enhanced preventive cardiovascular strategies.