title: The relationship between cardio-ankle vascular index and subclinical atherosclerosis evaluated by cardiac computed tomographic angiography.
abstract: BACKGROUND
  The cardio-ankle vascular index (CAVI) is a new noninvasive index to evaluate arterial stiffness. We investigated whether CAVI can predict severity, extent, and burden of coronary artery disease by comparing results with cardiac computed tomographic angiography (CCTA).
  
  
  OBJECTIVE
  CAVI may predict the presence of subclinical atherosclerosis.
  
  
  METHODS
  We prospectively enrolled 95 patients (66% male; mean age, 50 ± 16 years) who underwent both CCTA and CAVI consecutively. We evaluated if CAVI correlated with (1) severe stenosis (≥50%); (2) plaque extent, determined by a segment-involvement score (SIS), defined by the total number of coronary artery segments containing any plaque; and (3) plaque burden, determined by a segment-stenosis score (SSS), defined by the extent of obstruction of coronary luminal diameter in individual coronary artery segments.
  
  
  RESULTS
  Bivariate analysis showed a statistically significant relationship not only between CAVI and SIS, but also between CAVI and SSS (r2= 0.4, P < 0.0001 for SIS; r2= 0.36, P < 0.0001 for SSS). Multivariable logistic analysis demonstrated that CAVI is significantly associated with SSS >5 (odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1-7.8, P = 0.03) and SIS >5 (OR: 2.3, 95% CI: 1.1-5.8, P = 0.02), but not severe stenosis (OR: 1.7, 95% CI: 0.9-4.3, P = 0.13), after adjusting for age, sex, chest pain, hypertension, dyslipidemia, family history, diabetes, and current smoking.
  
  
  CONCLUSIONS
  We demonstrated that CAVI had a significant relationship with subclinical coronary atherosclerosis evaluated by CCTA, especially in relation to plaque burden and plaque extent, but not severe stenosis. Thus, CAVI may reflect coronary atherosclerosis burden more than severity.
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Suguru
authors.identifier: http://orcid.org/0000-0002-0366-5812
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Yanting
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.|Department of Cardiology, University of Florida, Gainesville.
authors.forename: Anas
authors.initials: A
authors.lastname: Alani
authors.affiliation: Department of Cardiology Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Negin
authors.initials: N
authors.lastname: Nezarat
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dailing
authors.affiliation: Department of Cardiology Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010865:Pilot Projects; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: cardiac computed tomography angiopgaphy; cardio-ankle vascular index; subclinical atherosclerosis