Association of cardio-ankle vascular index with cardiovascular risk factors and cardiovascular events in metabolic syndrome patients

Objectives: We aimed to investigate the association between arterial stiffness assessed as cardio-ankle vascular index (CAVI) and cardiovascular (CV) risk factors and CV events in the middle-aged metabolic syndrome (MS) patients. Materials and methods: A follow-up study was carried out in 2106 middle-aged (53.83 +/- 6.17 years old, 62% women) MS subjects without overt atherosclerotic disease. Patients were initially recruited in 2009-2011 as participants of the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program and followed up for 3.8 +/- 1.7 years for CV events. Thorough cardiometabolic risk assessment was carried out at inclusion. Results: Subjects with higher CAVI had worse lipid and glucose metabolism profile: elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), decreased high-density lipoprotein cholesterol (HDL-C), higher fasting and oral glucose tolerance test (OGTT) glucose levels (all P < 0.001), and lower fasting insulin (P = 0.021). Greater age (P < 0.001), heart rate (P = 0.016), and mean arterial pressure (P < 0.001) were also associated with higher CAVI. Over the follow-up period, 93 (4.4%) patients developed a cardiovascular event: 55 (2.6%) patients had myocardial infarction and 38 (1.8%) suffered a cerebrovascular event. Fatal CV events comprised 6.5% (n = 6) of all CV events. CAVI was statistically significantly associated with occurrence of myocardial infarction (P = 0.027) and total cardiovascular events (P = 0.045), but not cerebrovascular events (P = 0.65). However, this association was dependent on age and gender. Conclusions: In the middle-aged MS patients, higher CAVI was associated with altered lipid and glucose metabolism, older age, greater heart rate and mean arterial pressure, and worse cardiovascular outcome. (C) 2015 Lithuanian University of Health Sciences. Production and hosting by Elsevier Sp. z o.o.