Clinical Significance of Cardio-Ankle Vascular Index as a Cardiovascular Risk Factor in Elderly Patients With Type 2 Diabetes Mellitus

Abstract

BackgroundThe cardio-ankle vascular index (CAVI) is a novel physiological marker of atherosclerosis that reflects systemic arterial stiffness. The aim of this study was to clarify the clinical significance of CAVI as a risk factor for cardiovascular diseases (CVDs) in elderly patients with type 2 diabetes mellitus.MethodsThis cross-sectional study enrolled 216 elderly (≥ 65 years) outpatients with type 2 diabetes mellitus who were undergoing antidiabetic treatment (96 males and 120 females; mean age, 75 ± 7 years (mean ± standard deviation)). Associations between CAVI and various clinical parameters were examined.ResultsCAVI was significantly higher in patients with a history of CVD than in those without a history of CVD (10.4 ± 1.4 vs. 9.5 ± 1.0, respectively, P < 0.001). There were significantly positive correlations between CAVI and various clinical parameters, such as skin autofluorescence (r = 0.47, P < 0.001), high-sensitivity cardiac troponin T levels (r = 0.39, P < 0.001), and reactive oxygen metabolite levels (r = 0.28, P < 0.001). Furthermore, multiple regression analyses revealed that these clinical parameters ((skin autofluorescence (β = 0.30, P < 0.001), high-sensitivity cardiac troponin T levels (β = 0.18, P < 0.001), reactive oxygen metabolite levels (β = 0.15, P < 0.01), and a history of CVD (β = 0.19, P < 0.001)) were independent variables when CAVI was used as a subordinate factor.ConclusionFindings of this study indicate that CAVI may be an important CVD risk factor in elderly patients with type 2 diabetes mellitus. Further investigations in a large number of prospective studies, including intervention therapies, are required to validate our results.

Clinical Significance of Skin Autofluorescence in Patients With Type 2 Diabetes Mellitus With Chronic Heart Failure

“…Basic studies have reported that AGEs or RAGE can induce inflammation, oxidative stress, and calcification in vascular cells, such as endothelial or smooth muscle cells [ 32 - 34 ]. Clinical studies have also indicated a significant association between skin AF and physiological markers of arterial function, including CAVI [ 35 - 37 ]. On the contrary, some researchers have shown the importance of arterial function in the pathogenesis of CHF [ 38 , 39 ].…”

Usefulness of the Whole Blood Passage Time as a Predictor of Primary Cardiovascular Events in Patients With Traditional Cardiovascular Risk Factors

“…CAVI provides a novel marker of systemic arterial stiffness that is independently associated with blood pressure [ 12 ]. A number of studies have reported the clinical usefulness of CAVI as a cardiovascular risk factor [ 34 - 36 ]. In the present study, CAVI > 9 was one of the strongest predictors of MACE of all the explanatory variables.…”

Atherosclerosis as a predictor of transient exacerbation of overactive bladder symptoms after robot‐assisted laparoscopic radical prostatectomy

“…The CAVI before RARP was used to evaluate the severity of atherosclerosis . The CAVI was measured with a VaSera VS‐1000 (Fukuda Denshi, Tokyo, Japan) by the methods described previously . According to the manufacturer's recommendations, a CAVI <8 was considered normal; 8≤ CAVI <9 was considered borderline; and a CAVI ≥9 was considered abnormal .…”

“…13 The CAVI was measured with a VaSera VS-1000 (Fukuda Denshi, Tokyo, Japan) by the methods described previously. 12,14 According to the manufacturer's recommendations, a CAVI <8 was considered normal; 8≤ CAVI <9 was considered borderline; and a CAVI ≥9 was considered abnormal. 15 Patients with a CAVI ≥9 have been reported to have significantly higher mean and maximum intima-media thicknesses.…”