Physical Examination Center, The 1st Affiliated Hospital of Anhui Medical University, Hefei, China.
Hypertens Res. 2013 Apr;36(4):334-41. doi: 10.1038/hr.2012.192. Epub 2013 Jan 17.
The cardio-ankle vascular index (CAVI) has been widely accepted as a good indicator of arteriosclerosis. However, the lack of a reliable diagnostic criterion for CAVI hampers the proper clinical screening for arteriosclerosis using CAVI and impedes the prompt treatment of cardiovascular disease (CVD). There is an urgent need to determine a criterion for CAVI in arteriosclerosis prevention. We conducted a cross-sectional study to determine this criterion based on receiver operating characteristic (ROC) analyses in a Chinese population consisting of 328 participants. CAVI was measured in duplicate, and carotid ultrasound detection was performed in a quiet environment by well-trained physicians. After multivariate adjustment, CAVI was positively associated with the risk of carotid arteriosclerosis. Compared with participants in the lowest tertile of CAVI (5.15-7.40), those in the medium (7.41-8.65) and highest (8.66-13.60) tertiles had odds ratios (95% confidence interval) of 2.2 (1.0, 4.9) and 4.4 (1.5, 13.3), respectively, for developing carotid arteriosclerosis (P trend=0.007). The areas under the ROC curve (AUC) of the male, female and pooled populations were 0.789, 0.897 and 0.856, respectively. The cutoff point of CAVI≥8.0 resulted in the largest sensitivity and specificity. Furthermore, CAVI and age acted synergistically to increase the risk of carotid arteriosclerosis. CAVI≥8.0 may be an optimal cutoff point for carotid arteriosclerosis prediction. The older population with higher CAVI scores had a higher risk of carotid arteriosclerosis. Additional large prospective studies are needed to confirm our findings.
心血管踝臂指数(CAVI)已被广泛接受为动脉硬化的良好指标。然而,由于缺乏可靠的 CAVI 诊断标准,CAVI 无法在临床上用于动脉硬化的适当筛查,也无法及时治疗心血管疾病(CVD)。因此,迫切需要确定动脉硬化预防的 CAVI 标准。我们进行了一项横断面研究,通过对 328 名中国参与者的接受者操作特征(ROC)分析来确定该标准。CAVI 进行了两次测量,颈动脉超声检测在安静的环境中由经过良好培训的医生进行。经过多变量调整后,CAVI 与颈动脉粥样硬化的风险呈正相关。与 CAVI 最低三分位(5.15-7.40)的参与者相比,CAVI 中三分位(7.41-8.65)和最高三分位(8.66-13.60)的参与者发生颈动脉粥样硬化的比值比(95%置信区间)分别为 2.2(1.0,4.9)和 4.4(1.5,13.3)(P 趋势=0.007)。男性、女性和总人群的 ROC 曲线下面积(AUC)分别为 0.789、0.897 和 0.856。CAVI≥8.0 的切点导致最大的敏感性和特异性。此外,CAVI 和年龄协同作用增加了颈动脉粥样硬化的风险。CAVI≥8.0 可能是颈动脉粥样硬化预测的最佳切点。CAVI 评分较高的老年人群颈动脉粥样硬化的风险更高。需要进一步的大型前瞻性研究来证实我们的发现。