Predictive Value of the Cardio‐Ankle Vascular Index for Cardiovascular Events in Patients at Cardiovascular Risk
Authors: Miyoshi Toru , Ito Hiroshi , Shirai Kohji , Horinaka Shigeo , Higaki Jitsuo , Yamamura Shigeo , Saiki Atsuhito , Takahashi Mao , Masaki Mitsuru , Okura Takafumi , Kotani Kazuhiko , Kubozono Takuro , Yoshioka Ryo , Kihara Hajime , Hasegawa Koji , Satoh‐Asahara Noriko , Orimo Hajime , Akasaki Yuichi , Asahara Noriko , Doi Masayuki , Fukuoka Tomikazu , Fukushima Hiromichi , Hara Yuji , Hasegawa Koji , Hirano Keiichi , Hitsumoto Takashi , Honda Toshio , Horinaka Shigeo , Ichinari Kotaro , Ishimitsu Toshihiko , Ishimura Kimihiko , Iwataki Mai , Kaieda Hiroshi , Kajiya Masahito , Kamikawa Shigeshi , Kaneko Hitoshi , Kawakami Hideo , Kihara Hajime , Kikuchi Yuko , Kiyokawa Hajime , Kobayashi Takashi , Koguchi Wataru , Koizumi Mitsuteru , Kubozono Takuro , Maguchi Motofumi , Minowa Hitoshi , Miyamoto Michiaki , Miyoshi Akihito , Miyoshi Kenichi , Miyoshi Toru , Murata Maki , Murata Mitsunobu , Nagao Tomoaki , Nakamura Kazufumi , Nakamura Keigo , Nakamura Michitsugu , Nakano Nobuyuki , Nanba Seiji , Nishimura Kazuhisa , Obata Hachiro , Ogurusu Kazuro , Oka Takefumi , Okura Takafumi , Onimaru Madoka , Ono Shiro , Onoue Go , Saiki Atsuhito , Sakuragi Satoru , Sarashina Toshihiro , Seta Koichi , Shibata Yoshimasa , Shimizu Kazuhiro , Shirai Kohji , Sugiyama Hiroyasu , Sumimoto Takumi , Takahashi Sho , Takehana Hitoshi , Takeshima Hiroshi , Todoroki Masakatsu , Tominaga Youkou , Uraoka Tadao , Yagi Hiroshi , Yahata Kensei , Yoshioka Ryo , Takata Masanobu , Otsuka Kuniaki , Oikawa Shinichi , Yamamura Shigeo 
Published: August 2021

Background
Arterial stiffness is an important predictor of cardiovascular events; however, indexes for measuring arterial stiffness have not been widely incorporated into routine clinical practice. This study aimed to determine whether the cardio‐ankle vascular index (CAVI), based on the blood pressure–independent stiffness parameter β and reflecting arterial stiffness from the origin of the ascending aorta, is a good predictor of cardiovascular events in patients with cardiovascular disease risk factors in a large prospective cohort.

Methods and Results

This multicenter prospective cohort study, commencing in May 2013, with a 5‐year follow‐up period, included patients (aged 40‒74 years) with cardiovascular disease risks. The primary outcome was the composite of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. Among 2932 included patients, 2001 (68.3%) were men; the mean (SD) age at diagnosis was 63 (8) years. During the median follow‐up of 4.9 years, 82 participants experienced primary outcomes. The CAVI predicted the primary outcome (hazard ratio, 1.38; 95% CI, 1.16‒1.65;
P
<0.001). In terms of event subtypes, the CAVI was associated with cardiovascular death and stroke but not with myocardial infarction. When the CAVI was incorporated into a model with known cardiovascular disease risks for predicting cardiovascular events, the global χ
2
value increased from 33.8 to 45.2 (
P
<0.001), and the net reclassification index was 0.254 (
P
=0.024).

Conclusions
This large cohort study demonstrated that the CAVI predicted cardiovascular events.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01859897.