The following is a summary of “Prognostic Value of Cardio-Ankle Vascular Index for Cardiovascular and Kidney Outcomes: Systematic Review and Meta-Analysis,” published in the issue of Cardiology by Tavolinejad et al.

Stiff arteries lead to heart and organ issues. Carotid-femoral pulse wave velocity is the go-to measure, but the predictive power of the cardio-ankle vascular index (CAVI), which adjusts for blood pressure, needs more exploration. 

Researchers conducted a retrospective study investigating the predictive ability of CAVI in measuring cardiovascular risks and kidney outcomes. 

They reviewed PubMed, Scopus, and Web of Science (May 6, 2023) for studies examining CAVI’s association with mortality, cardiovascular events (CVEs) (including death, acute coronary syndromes, stroke, coronary revascularization, heart failure hospitalization), and kidney function decline (incidence/progression of chronic kidney disease, glomerular filtration rate decline). Random-effects meta-analysis was performed, and studies were assessed using the “Quality in Prognostic Studies” tool. 

The results showed that 32 studies with (105,845 participants, follow-up of 12-148) were systematically reviewed, and CAVI cutoffs varied. High CAVI linked to increased risk of CVEs (HR: 1.46 [95% CI: 1.22-1.75]; P<0.001; I²=41%) and per SD/unit CAVI increase (HR: 1.30 [95% CI: 1.20-1.41]; P< 0.001; I²= 0%). Among participation without baseline cardiovascular disease, higher CAVI was linked with first-time CVEs (high vs. normal: HR: 1.60 [95% CI: 1.15-2.21]; P=0.005, I²=65%; HR per SD/unit increase: 1.28 [95% CI: 1.12-1.47]; P<0.001; I²=18%) and kidney function decline (high vs normal: HR = 1.30 [1.18-1.43]; P< 0.001; I² = 38%; HR per SD/unit increase: 1.12 [95% CI: 1.07-1.18]; P< 0.001; I² = 0%). No significant association was found with mortality (HR= 1.31 [0.92-1.87]; P=0.130; I²=53%). 

Investigators concluded that higher CAVI predicts new CVEs, even in those without prior heart issues, including a link between elevated CAVI and declining kidney function.

Source: jacc.org/doi/10.1016/j.jacadv.2024.101019