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Comparison of Atherosclerotic Indicators Between Cardio Ankle Vascular Index and Brachial Ankle Pulse Wave Velocity

Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan, horinaka{at}dokkyomed.ac.jp

Akihisa Yabe, MD, PhD

Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

Hiroshi Yagi, MD, PhD

Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

Kimihiko Ishimura, MD, PhD

Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

Hitoshi Hara, MD, PhD

Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

Tomoyuki Iemua, MD

Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

Hiroaki Matsuoka, MD, PhD

Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

Background: Aortic pulse wave velocity has been used for evaluating atherosclerosis. Recently, the development of the volume plethysmographic method has made it possible to easily measure the index of the pulse wave velocity. The brachial ankle pulse wave velocity and cardio ankle vascular index are used for estimating the extent of atherosclerosis. The diagnostic usefulness of these indexes in predicting coronary artery disease was examined. Methods: The brachial ankle pulse wave velocity, the cardio ankle vascular index, and the high-sensitivity C-reactive protein were measured in 696 patients who had chest pain and underwent coronary angiography. Measurement values of brachial ankle pulse wave velocity were compared with those of cardio ankle vascular index in terms of the baseline covariates and the number of major coronary vessels involved (vessel disease). Results: The brachial ankle pulse wave velocity was significantly correlated with age, systolic blood pressure, and diastolic blood pressure but not with the high-sensitivity C-reactive protein. The cardio ankle vascular index was correlated only with age and the high-sensitivity C-reactive protein. The average of both brachial ankle pulse wave velocity and cardio ankle vascular index values was greater in 3 vessel disease group than in 0 vessel disease group. The receiver operating characteristic curve showed that the diagnostic accuracy of coronary artery disease was significantly higher in the cardio ankle vascular index than in the brachial ankle pulse wave velocity (area under the curve ± standard error: 0.691 ± 0.025 vs. 0.584 ± 0.026; P < .05). Conclusions: As a means of estimating the extent of atherosclerosis in large arteries, our results show that both brachial ankle pulse wave velocity and cardio ankle vascular index are useful and that cardio ankle vascular index may have some advantages in its application to patients taking blood pressure—lowering medication because of the minimum effect of blood pressure on its measurement values. The cardio ankle vascular index has increased performance over brachial ankle pulse wave velocity in predicting the coronary artery disease.

Key Words: brachial ankle pulse wave velocity • cardio ankle vascular index • coronary artery disease • atherosclerosis • high-sensitivity C-reactive protein

This version was published on August 1, 2009

Angiology, Vol. 60, No. 4, 468-476 (2009)
DOI: 10.1177/0003319708325443


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