Author + information
- Jee Eun Kwon,
- Sang-Wook Kim,
- Wang-Soo Lee,
- Joon Hwa Hong,
- Sharath Kumar,
- Eun Young Kim,
- Kwang Je Lee,
- Chee Jeong Kim,
- Dai Yun Cho and
- Tae Ho Kim
Cardio-Ankle Vascular Index (CAVI) was developed as a parameter of atherosclerosis that does not depend on the blood pressure than pulse wave velocity (PWV). We assessed the predictive value of CAVI as an indicator of coronary artery disease and whether it reflects the severity of CAD.
We assessed CAVI in 474 patients before undergoing coronary angiography. 207 patients had normal coronary angiogram, and 267 patients were confirmed to have coronary artery disease. IVUS analysis of the culprit lesion was done. VH-IVUS-defined thin-capped fibroatheroma (VH-TCFA) had necrotic core (NC) >10% of plaque area, plaque burden >40%, and NC in contact with the lumen for ≥3 image slices.
CAVI was higher in patients with coronary artery disease than normal patients (8.96±1.54 vs 8.03±1.39, p=0.03). Among patient with coronary artery disease, patients with multi-vessel disease showed higher value of CAVI (8.76±1.53 vs 8.23±1.26, p=0.001). IVUS analysis of the culprit lesion was amenable in 102 pts who were divided into 2 groups: CAVI< 9(52pts) and CAVI≥ 9(50pts). While minimal lumen area, plaque burden and remodeling index were similar, lesion length were longer in CAVI ≥ 9 group. CAVI showed correlation with lesion length (r=0.615, p<0.001), whereas not with minimal lumen area (r=-0.048, p=0.672). Among 4 components (fibrotic, fibrofatty, necrotic, calcium), lesion maximal calcium (%) was higher in CAVI ≥ 9 group and also showed correlation with CAVI (r=0.521, p<0.001). The frequency of VH-TCFA phenotype was similar between the two groups (19/52 (36.5%) vs 17/50(34%), p=0.263).
High CAVI value might suggest more severe (longer lesion length) and greater coronary artery disease complexity (more calcified coronary plaque).
|CAVI < 9 (n=52)||CAVI ≥ 9 (n=50)||P value|
|Lesion length (mm)||15.94±5.86||20.68±5.76||<0.001|
|Distal reference lumen area (mm2)||6.71±3.28||7.03±2.52||0.619|
|MLA lumen area (mm2)||2.66±1.15||2.59±0.84||0.941|
|MLA plaque burden (%)||78.37±8.58||78.78±7.60||0.823|
|Remodeling index (MLA site)||0.84±0.18||0.78±0.16||0.117|
|Necrotic core (% ) (max. NC site)||33.87±9.41||32.83±9.09||0.614|
|Dense calcium (%) (max. NC site)||9.12±8.02||9.82±7.18||0.682|
|Lesion Max. dense calcium (%)||11.48±10.43||18.71±10.59||0.003|