Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus.
- Author:
So Young PARK
1
;
Sang Ook CHIN
;
Sang Youl RHEE
;
Seungjoon OH
;
Jeong Taek WOO
;
Sung Woon KIM
;
Suk CHON
Author Information
- Publication Type:Original Article
- Keywords: Atherosclerosis; Cardiovascular diseases; Diabetes mellitus, type 2; Korea
- MeSH: Ankle Brachial Index; Atherosclerosis; Biomarkers*; Blood Pressure; Cardiovascular Diseases*; Carotid Arteries; Complement System Proteins; Confounding Factors (Epidemiology); Diabetes Mellitus, Type 2*; Humans; Korea; Odds Ratio; Pulse Wave Analysis; Retrospective Studies; Risk Factors
- From:Diabetes & Metabolism Journal 2018;42(4):285-295
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Carotid artery intima medial thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) are commonly used surrogate markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The cardio-ankle vascular index (CAVI) is a complement to the baPWV, which is affected by blood pressure. However, it is unclear which marker is the most sensitive predictor of atherosclerotic cardiovascular disease (ASCVD). METHODS: This was a retrospective non-interventional study that enrolled 219 patients with T2DM. The correlations among IMT, ABI, and CAVI as well as the relationship of these tests to the 10-year ASCVD risk were also analyzed. RESULTS: Among the 219 patients, 39 (17.8%) had ASCVD. In the non-ASCVD group, CAVI correlated significantly with IMT after adjusting for confounding variables, but ABI was not associated with CAVI or IMT. The analyses after dividing the non-ASCVD group into three subgroups according to the CAVI score ( < 8, ≥8 and < 9, and ≥9) demonstrated the significant increase in the mean IMT, 10-year ASCVD risk and number of metabolic syndrome risk factors, and decrease in the mean ABI in the high-CAVI group. A high CAVI was an independent risk factor in the non-ASCVD group for both a high 10-year ASCVD risk (≥7.5%; odds ratio [OR], 2.42; P < 0.001) and atherosclerosis (mean IMT ≥1 mm; OR, 1.53; P=0.007). CONCLUSION: In Korean patients with T2DM without ASCVD, CAVI was the most sensitive of several surrogate markers for the detection of subclinical atherosclerosis.
