Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus

Abstract

BackgroundCarotid artery intima medial thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) are commonly used surrogate markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The cardio-ankle vascular index (CAVI) is a complement to the baPWV, which is affected by blood pressure. However, it is unclear which marker is the most sensitive predictor of atherosclerotic cardiovascular disease (ASCVD).MethodsThis was a retrospective non-interventional study that enrolled 219 patients with T2DM. The correlations among IMT, ABI, and CAVI as well as the relationship of these tests to the 10-year ASCVD risk were also analyzed.ResultsAmong the 219 patients, 39 (17.8%) had ASCVD. In the non-ASCVD group, CAVI correlated significantly with IMT after adjusting for confounding variables, but ABI was not associated with CAVI or IMT. The analyses after dividing the non-ASCVD group into three subgroups according to the CAVI score (<8, ≥8 and <9, and ≥9) demonstrated the significant increase in the mean IMT, 10-year ASCVD risk and number of metabolic syndrome risk factors, and decrease in the mean ABI in the high-CAVI group. A high CAVI was an independent risk factor in the non-ASCVD group for both a high 10-year ASCVD risk (≥7.5%; odds ratio [OR], 2.42; P<0.001) and atherosclerosis (mean IMT ≥1 mm; OR, 1.53; P=0.007).ConclusionIn Korean patients with T2DM without ASCVD, CAVI was the most sensitive of several surrogate markers for the detection of subclinical atherosclerosis.

<p>The Relationship Between Glycemic Control and Concomitant Hypertension on Arterial Stiffness in Type II Diabetes</p>

“…CAVI was positively correlated with intima media thickness and 10-year atherosclerotic cardiovascular disease risk in T2D patients. 23 Thus, CAVI is a simple but effective marker of arterial stiffness and cardiovascular disease. In this study, an abnormal CAVI was defined as CAVI ≥ 8, which included borderline and suspected arterial stiffness.…”

Short‑term impact of aged garlic extract on endothelial function in diabetes: A randomized, double‑blind, placebo‑controlled trial

“…To the best of our knowledge, this is the first study to demonstrate the effects of AGE on arterial stiffness by improving endothelial function, which was measured by CAVI over a period of 3 months in patients with type 2 diabetes. Diabetic patients with a high 10-year atherosclerotic cardiovascular disease (ASCVD) risk score have been noted to have high CAVI (>9) (15). CAVI is independent of blood pressure and highly reproducible, which is significantly higher in patients with coronary artery stenosis (1,6-9,16).…”

Cardiovascular remodeling in patients with diabetic сardiomyopathy

“…Предпосылкой к тому, что у больных ДКМ происходят параллельные процессы перестройки и сердца и сосудов, стал ретроспективный анализ Park SY, et al, в котором при обследовании 219 больных с СД 2 типа без патологии сердца и сосудов найдено, что индекс CAVI1, отражающий истинную жесткость артерий не зависящую от АД, является наиболее чувствительным ранним маркером развития сердечно-сосудистого заболевания атеросклеротического генеза [13]. Аналогичные данные были получено ранее в наблюдательном исследовании LOD-DIABETES (Central Blood Pressure and Pulse Wave Velocity: Relationship to Target Organ Damage and Cardiovascular Morbidity-mortality in Diabetic Patients.…”