Brachial–ankle pulse wave velocity, cardio-ankle vascular index, and prognosis

Abstract

Background

Brachial–ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) are indices of arterial stiffness, and several studies have used these indices. However, there is no comprehensive review of these parameters in the prognostic significance.

Methods

The aim of this study was to review the articles exploring the prognostic significance of these parameters. Articles demonstrating independent significance after multivariate analysis on the Cox proportional hazards model were defined as “successful.” The success rate was compared using Fisher’s exact test. In addition, multivariate logistic regression analysis was performed to explore the independent determinants of the success of prognostic prediction.

Results

The success rate of the baPWV articles (65.7% [46/70]) tended to be higher than that of the CAVI articles (40.0% [6/15]; P=0.083). Multivariate analysis demonstrated that log (number of patients) (OR 11.20, 95% CI 2.45–51.70, P=0.002) and dialysis population (OR 0.28, 95% CI 0.08–0.94, P=0.039) were positive and negative independent determinants of the success of prognostic prediction, respectively. In addition, after redefining two studies as the absence of arteriosclerosis obliterans (ASO) exclusion, baPWV (OR 3.36, 95% CI 0.86–13.20, P=0.083) and the existence of exclusion criteria of ASO (OR 3.08, 95% CI 0.96–9.93, P=0.060) exhibited statistical tendency in the multivariate analysis.

Conclusion

This study demonstrated that the number of study participants and dialysis population were the independent determinants of the success of prognostic prediction. This study also showed the importance of exclusion criteria of ASO when using these indices. In addition, a prospective large-scale study to confirm the superiority in the prognostic prediction of these indices is warranted.

Keywords:

• peripheral arterial disease
• ankle–brachial index
• diabetes
• hemodialysis
• cardio-vascular events

Supplementary material

Table S1 Logistic regression analysis after redefining three studies (five studies in total)

Acknowledgments

The author appreciates the researchers and participants of the preceding studies.

Disclosure

Dai Ato is a former employee of Fukuda Colin (formerly Omron Colin, Nippon Colin) Co., Ltd. Fukuda Colin is a distributor of VP (form PWV/ABI, BP-203RPE series). Dai Ato wrote this article as an academic activity based on the guaranteed right of freedom in academia for the Japanese (Article 23) and on the supreme law provided in Article 98 of the Constitution of Japan. Dai Ato reports no other conflicts of interest in this work.