Predictive value of the cardio-ankle vascular index for cardiovascular events in patients at cardiovascular risk

on behalf of the CAVI-J (Prospective Multicenter Study to Evaluate Usefulness of Cardio-Ankle Vascular Index in Japan) investigators*

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


BACKGROUND: Arterial stiffness is an important predictor of cardiovascular events; however, indexes for measuring arterial stiffness have not been widely incorporated into routine clinical practice. This study aimed to determine whether the cardio-ankle vascular index (CAVI), based on the blood pressure–independent stiffness parameter β and reflecting arterial stiffness from the origin of the ascending aorta, is a good predictor of cardiovascular events in patients with cardiovascular disease risk factors in a large prospective cohort. METHODS AND RESULTS: This multicenter prospective cohort study, commencing in May 2013, with a 5-year follow-up period, included patients (aged 40‒74 years) with cardiovascular disease risks. The primary outcome was the composite of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. Among 2932 included patients, 2001 (68.3%) were men; the mean (SD) age at diagnosis was 63 (8) years. During the median follow-up of 4.9 years, 82 participants experienced primary outcomes. The CAVI predicted the primary outcome (hazard ratio, 1.38; 95% CI, 1.16‒1.65; P<0.001). In terms of event sub-types, the CAVI was associated with cardiovascular death and stroke but not with myocardial infarction. When the CAVI was incorporated into a model with known cardiovascular disease risks for predicting cardiovascular events, the global χ2 value increased from 33.8 to 45.2 (P<0.001), and the net reclassification index was 0.254 (P=0.024). CONCLUSIONS: This large cohort study demonstrated that the CAVI predicted cardiovascular events.

Original languageEnglish
Article numbere020103
JournalJournal of the American Heart Association
Issue number16
Publication statusPublished - Aug 17 2021


  • Arterial stiffness
  • Blood pressure
  • Cardiovascular events
  • Pulse-wave velocity
  • Risk factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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