Cardio-Ankle Vascular Index Predicts Post-Discharge Stroke in Patients with Heart Failure

Abstract

We aimed to evaluate the significance of the cardio-ankle vascular index (CAVI) to predict stroke in patients with heart failure (HF).Methods: This was a prospective observational study, which recruited clinical data from a total of 557 patients who had been hospitalized for HF and undergone CAVI. According to the receiver operating characteristic curve analysis, the accurate cut-off value of CAVI in predicting post-discharge stroke was 9.64. We divided the patients into two groups: the high-CAVI group (HF patients with CAVI ≥ 9.64, n 111, 19.9%) and the low-CAVI group (HF patients with CAVI 9.64, n 446, 80.1%). We compared the patients' characteristics and post-discharge prognosis. The primary endpoint was stroke. Results:The high-CAVI group was older (73.0 vs. 65.5 years old, P 0.001). Male sex (73.9% vs. 61.4%, P 0.015), coronary artery disease (47.7% vs. 36.1%, P 0.024), and diabetes mellitus (54.1% vs. 37.4%, P 0.001) were more prevalent in the high-CAVI group. In contrast, there was no difference in left ventricular ejection fraction, and prevalence of hypertension and dyslipidemia. The Kaplan-Meier analysis demonstrated that post-discharge stroke rate was higher in the high-CAVI group than in the low-CAVI group (log-rank P 0.005). In multivariate Cox proportional hazard analysis, high CAVI was found to be an independent predictor of stroke, with an adjusted hazard ratio of 3.599, compared to low CAVI. Conclusion: CAVI independently predicts stroke in patients with HF.The trial registration number: UMIN000029132 pendently of BP, non-invasively represents the stiffness of the aorta, femoral artery, and tibial artery 6) . The formula of the index is as follows: CAVI a [(2 / P) ln (systolic BP / diastolic BP) PWV 2 ] b, where is blood density, P is pulse pressure, and a and b are coefficients 6) . CAVI also estimates atherosclerosis in the coronary and carotid arteries more closely than PWV 7,8) . CAVI is useful not only for the evaluation of arterial stiffness, but also for prognosis prediction in patients who are at high risk of CVDs [9][10][11][12] . However,

The Association of Arterial Stiffness With Significant Carotid Atherosclerosis and Carotid Plaque Vulnerability

“…6 Novel evidence supports the prognostic power of arterial stiffness in the poststroke period as well. 29,30 In this context, our symptomatic patients undergoing CAS appeared with higher CAVI than their asymptomatic counterparts. Moreover, this is the first study, to our knowledge, demonstrating a positive, independent association of arterial stiffness with carotid plaque vulnerability as indicated by clinical or brain imaging evidence of past cerebrovascular event or low GSM levels, in patients with significant carotid stenosis.…”

Simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) Definition Predicts Bleeding Events in Patients With Heart Failure

“…16 Evidence of thrombotic risk in patients with HF has been accumulated but is not yet sufficient. 16,60,61 Clinicians should modulate antithrombotic therapy on the basis of balancing both thrombotic and hemorrhagic risk (i.e., simplified ARC-HBR definition) in each patient with HF. More evidence is (Saitama Medical Center, Jichi Medical University, Saitama, Japan), a graphical user interface for R (R Foundation for Statistical Computing, Vienna, Austria).…”

Carotid Artery Stiffness: Imaging Techniques and Impact on Cerebrovascular Disease

“…CAVI is a non-invasive method for measuring stiffness in the aorta, femoral, and tibial arteries and is strongly associated with the stiffness parameter ß ( 15 ). Further, there is evidence that CAVI is strongly associated with stroke and other cardiovascular events ( 16 , 17 ). While not routinely used in clinical practice, CAVI is another non-invasive measure of arterial stiffness which may provide valuable information regarding cardiovascular risk.…”