Clinical Impact of the Cardio-Ankle Vascular Index for Predicting Cardiovascular Events After Acute Coronary Syndrome.
BACKGROUND
We hypothesized the cardio-ankle vascular stiffness index (CAVI) could predict future cardiovascular events.


RESULTS
We enrolled 288 consecutive patients with acute coronary syndrome (ACS) who underwent CAVI measurement soon after the onset of ACS. Exclusion criteria were as follows: unable to detect significant stenosis by coronary angiography, severe aortic insufficiency, peripheral artery disease, atrial fibrillation (AF), informed consent was not given. We divided the patients into 2 groups according to the cutoff value of CAVI determined by receiver-operating characteristics curve for the prediction of cardiovascular events: low CAVI group, 135 patients with CAVI ≤8.325; high CAVI group, 153 patients with CAVI >8.325. Patients were followed up for a median period of 15 months. The primary and secondary endpoints were the incidence of cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal ischemic stroke), and nonfatal ischemic stroke. Of the 288 patients, cardiovascular events occurred in 19 patients (6.6%). The Kaplan-Meier estimate of the event-free rate revealed cardiovascular events occurred more frequently in the high CAVI group than in the low CAVI group (log-rank, P<0.001). Multiple adjusted Cox proportional hazards analysis, including age, indicated the high CAVI group was an independent predictor of cardiovascular events (hazard ratio [HR] 18.00, P=0.005), and nonfatal ischemic stroke (HR 9.371, P=0.034).


CONCLUSIONS
High CAVI is an independent predictor of cardiovascular events and nonfatal ischemic stroke in patients with ACS. (Circ J 2016; 80: 1420-1426).
Division of Cardiology, Yokohama City University Medical Center.
Masaomi
M
Gohbara
Noriaki
N
Iwahashi
Yuka
Y
Sano
Eiichi
E
Akiyama
Nobuhiko
N
Maejima
Kengo
K
Tsukahara
Kiyoshi
K
Hibi
Masami
M
Kosuge
Toshiaki
T
Ebina
Satoshi
S
Umemura
Kazuo
K
Kimura
D054058:Acute Coronary Syndrome / Q000150:complications* / Q000175:diagnosis; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis; D059289:Vascular Stiffness