CAVI IS A SIGNIFICANT INDICATOR IN PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE

Objective: This study aimed to assess the impact of Cardio-Ankle Vascular Index (CAVI), an arterial stiffness parameter independent of blood pressure, on the primary prevention of cardiovascular disease (CVD) through a sub-analysis of the CAVI-J (Prospective Multicenter Study to Evaluate Usefulness of Cardio-Ankle Vascular Index in Japan). Design and method: The study included 1,811 patients without a history of CV events, selected from an initial 2,932 patients who had at least one risk factor for CVD. Participants were followed for five years. The primary endpoint was the occurrence of cardiovascular events, including all-cause death, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, chronic coronary syndrome requiring percutaneous coronary intervention, new onset of peripheral artery disease, acute aortic dissection, and aortic aneurysm. The CAVI cut-off value was set at 8.65 based on ROC analysis. Results: Patients were divided into two groups based on their CAVI values: CAVI < 8.65 (978 patients) and CAVI > 8.65 (833 patients). Significant differences were observed between the two groups. Patients with CAVI > 8.65 were older (mean age 65.5 vs. 59.6 years), had a higher percentage of men (65.9% vs. 56.3%), and higher systolic blood pressure (137.4 vs. 132.6 mm Hg). During the follow-up period, 90 events were documented. Patients with CV events had significantly higher CAVI values (8.92 vs. 8.48, p < 0.001) compared to those without CV events. Multivariate Cox hazard ratio analysis indicated that a CAVI value > 8.65 was a significant predictor of future CV events (HR 1.64, 95% CI 1.04-2.59, p = 0.033). Furthermore, each one-point increase in CAVI was associated with a higher risk of CV events (HR 1.27, 95% CI 1.05-1.53, p = 0.014). The incorporation of CAVI into a model with known cardiovascular risks for predicting cardiovascular events increased the global chi-square value from 15.6 to 20.7 (P = 0.014) and yielded a net reclassification index of 0.313 (P = 0.004). Conclusions: Elevated CAVI values were significantly associated with an increased risk of CV events. Including CAVI in risk assessment models improved their predictive accuracy in patients without a history of CVD.