Change in cardio-ankle vascular index by long-term continuous positive airway pressure therapy for obstructive sleep apnea

Kato, Megumi; Kumagai, Takiko; Naito, Ryo; Maeno, Ken-ichi; Kasagi, Satoshi; Kawana, Fusae; Ishiwata, Sugao; Narui, Koji; Kasai, Takatoshi

doi:10.1016/j.jjcc.2011.03.005

Cited by 21 publications

(13 citation statements)

References 42 publications

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“…This suggested that serial assessments of arterial stiffness using CAVI could serve as an indicator of the need for treatment. Moreover, several interventional studies showed that nonpharmacological and pharmacological treatments were associated with an improvement in CAVI [27][28][29] . To determine the utility of CAVI in patients with ACS, more clinical and experimental studies are required.…”

Section: Discussionmentioning

confidence: 99%

Impact of Cardio-Ankle Vascular Index on Long-Term Outcome in Patients with Acute Coronary Syndrome

Kirigaya

Iwahashi

Tahakashi

et al. 2020

JAT

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The purpose of this study is to investigate the impact of arterial stiffness assessed using Cardio-ankle Vascular Index (CAVI) on long-term outcome after acute coronary syndrome (ACS). Methods: A total of 387 consecutive patients (324 males; age, 64 11 years) with ACS were enrolled. We examined CAVI and brachial-ankle pulse wave velocity (ba PWV) as the parameters of arterial stiffness. The patients were divided into two groups according to the cutoff value of CAVI determined using the receiver operating characteristic curve for the prediction of major adverse cardiovascular events (MACE): low-CAVI group, 177 patients with CAVI 8.35; high-CAVI group, 210 patients with CAVI ≥ 8.35. The primary endpoint was the incidence of MACE (cardiovascular death, recurrence of ACS, heart failure requiring hospitalization, or stroke). Results: A total of 62 patients had MACE. Kaplan-Meier analysis demonstrated a significantly higher probability of MACE in the high-CAVI group than in the low-CAVI group (median follow-up: 62 months; log-rank, p 0.001). Multivariate analysis suggested that CAVI was an independent predictor of MACE (hazard ratio [HR], 1.496; p 0.02) and cardiovascular death (HR, 2.204; p 0.025), but ba PWV was not. We investigated the incremental predictive value of adding CAVI to the GRACE score (GRS), a validated scoring system for risk assessment in ACS. Stratified by CAVI and GRS, a significantly higher rate of MACE was seen in patients with both higher CAVI and higher GRS than the other groups (p 0.001). Furthermore, the addition of CAVI to GRS enhanced net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI, 0.337, p 0.034; and IDI, 0.028, p 0.004). Conclusion: CAVI was an independent long-term predictor of MACE, especially cardiovascular death, adding incremental clinical significance for risk stratification in patients with ACS. has attracted attention as a potentially useful parameter for risk stratification of patients with ACS 3, 4). Cardio-ankle vascular stiffness index (CAVI) is a noninvasive measure of arterial stiffness that is not influenced by blood pressure at the time of examination 5, 6). We previously reported that high CAVI was an independent predictor of cardiovascular (CV) events and nonfatal ischemic stroke in patients with ACS 3). However,

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Section: Discussionmentioning

confidence: 99%

Impact of Cardio-Ankle Vascular Index on Long-Term Outcome in Patients with Acute Coronary Syndrome

Kirigaya

Iwahashi

Tahakashi

et al. 2020

JAT

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“…Moreover, the benefits of CPAP on reduction of fatal and nonfatal CVD events have been established in multiple large trials [82]. It has also been clearly shown that after CPAP treatment in patients with OSA there was a significant improvement in all indices of AS [79,[83][84][85][86].…”

Section: As In Mets-associated Obstructive Sleep Apnea (Osa)mentioning

confidence: 98%

Treating Arterial Stiffness Associated with Features of Metabolic Syndrome Not Included in its Diagnostic Criteria: Cutting Off the Heads of Lernaean Hydra, Keeper of the Underworld

Athyros¹,

Ferlita²,

Τζιόμαλος³

et al. 2013

TOHYPERJ

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Abstract:The clustering of cardio-metabolic risk factors, regardless if this is called metabolic syndrome (MetS) or not, substantially increases the risk of cardiovascular disease (CVD) and all-cause mortality. One of the possible mechanisms of the rise in CVD incidence is the increase in arterial stiffness (AS), which is a significant and independent CVD risk factor. Hypertension has long been connected to AS. Besides MetS components (obesity, dyslipidaemia, hypertension, dysglycaemia), MetS-associated disease states, not included in the MetS diagnostic criteria (renal dysfunction, hyperuricaemia, non alcoholic fatty liver disease, obstructive sleep apnea, polycystic ovary syndrome and hypercoaglutability) have been implicated in the increase of CVD risk through the increase of AS, among other mechanisms. Treatment options for AS induced by these non-diagnostic features of MetS are discussed. The impact of lifestyle changes is analyzed. Among pharmacological interventions, statin treatment seams to hold a pivotal role. Furthermore, we discuss specific measures for each disease state separately.

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“…Moreover, the benefits of effective CPAP on reduction of CVD risk and fatal and nonfatal CVD events have been established in multiple large trials [77]. It has also been clearly shown that after CPAP treatment in patients with OSA there was a significant improvement of all indices of AS [74,[78][79][80].…”

Section: As In Mets and Obstructive Sleep Apnea (Osa)mentioning

confidence: 98%

Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review

et al. 2013

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The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS) or not, substantially increases the risk of cardiovascular disease (CVD) and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS), and in high central aortic blood pressure (CABP), which are significant and independent CVD risk factors. Arterial hypertension was connected to AS long ago; however, other MetS components (obesity, dyslipidaemia, dysglycaemia) or MetS associated abnormalities not included in MetS diagnostic criteria (renal dysfunction, hyperuricaemia, hypercoaglutability, menopause, non alcoholic fatty liver disease, and obstructive sleep apnea) have been implicated too. We discuss the evidence connecting these cardio-metabolic risk factors, which negatively affect AS and finally increase CVD risk. Furthermore, we discuss the impact of possible lifestyle and pharmacological interventions on all these cardio-metabolic risk factors, in an effort to reduce CVD risk and identify features that should be taken into consideration when treating MetS patients with or without arterial hypertension.

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Change in cardio-ankle vascular index by long-term continuous positive airway pressure therapy for obstructive sleep apnea

Cited by 21 publications

References 42 publications

Impact of Cardio-Ankle Vascular Index on Long-Term Outcome in Patients with Acute Coronary Syndrome

Impact of Cardio-Ankle Vascular Index on Long-Term Outcome in Patients with Acute Coronary Syndrome

Treating Arterial Stiffness Associated with Features of Metabolic Syndrome Not Included in its Diagnostic Criteria: Cutting Off the Heads of Lernaean Hydra, Keeper of the Underworld

Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review

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