■动脉僵硬导致心血管疾病和靶器官损害。颈动脉-股脉搏波速度被认为是标准的动脉僵硬度指标。然而,心踝血管指数(CAVI)的预后价值,对血压进行了数学校正,仍未研究。
■本研究的目的是确定CAVI与心血管和肾脏预后的相关性。
■PubMed,Scopus,和WebofScience一直搜索到2023年5月6日,纵向研究报告CAVI与死亡率的关联,心血管事件(CVEs)(包括死亡,急性冠脉综合征,中风,冠状动脉血运重建,心力衰竭住院),和肾功能下降(慢性肾脏病的发病率/进展,肾小球滤过率下降)。进行随机效应荟萃分析。使用“预后研究质量”工具评估研究。
■系统评价确定了32项研究(105,845名参与者;随访范围:12-148个月)。报告了CAVI的可变截止值。与正常CAVI相比,高CAVI的CVE风险更高(HR:1.46[95%CI:1.22-1.75];P<0.001;I2=41%),和每SD/单位CAVI增加(HR:1.30[95%CI:1.20-1.41];P<0.001;I2=0%)。在包括没有基线心血管疾病(一级预防)的参与者在内的研究中,较高的CAVI与首次CVE相关(高vs正常:HR:1.60[95%CI:1.15-2.21];P=0.005;I2=65%;HR/SD/单位增加:1.28[95%CI:1.12-1.47];P<0.001;I2=18%).CAVI与死亡率无相关性(HR=1.31[0.92-1.87];P=0.130;I2=53%)。CAVI与肾功能下降相关(高vs正常:HR=1.30[1.18-1.43];P<0.001;I2=38%;HR/单位增加:1.12[95%CI:1.07-1.18];P<0.001;I2=0%)。
■更高的CAVI与事件CVE相关,这种关联存在于一级预防环境中。CAVI升高与肾功能下降有关。
UNASSIGNED: Arterial stiffness causes cardiovascular disease and target-organ damage. Carotid-femoral pulse wave velocity is regarded as a standard arterial stiffness metric. However, the prognostic value of cardio-ankle vascular index (CAVI), which is mathematically corrected for blood pressure, remains understudied.
UNASSIGNED: The purpose of this study was to determine the association of CAVI with cardiovascular and kidney outcomes.
UNASSIGNED: PubMed, Scopus, and Web of Science were searched until May 6, 2023, for longitudinal studies reporting the association of CAVI with mortality, cardiovascular events (CVEs) (including death, acute coronary syndromes, stroke, coronary revascularization, heart failure hospitalization), and kidney function decline (incidence/progression of chronic kidney disease, glomerular filtration rate decline). Random-effects meta-analysis was performed. Studies were assessed with the \"Quality in Prognostic Studies\" tool.
UNASSIGNED: Systematic review identified 32 studies (105,845 participants; follow-up range: 12-148 months). Variable cutoffs were reported for CAVI. The risk of CVEs was higher for high vs normal CAVI (HR: 1.46 [95% CI: 1.22-1.75]; P < 0.001; I2 = 41%), and per SD/unit CAVI increase (HR: 1.30 [95% CI: 1.20-1.41]; P < 0.001; I2 = 0%). Among studies including participants without baseline cardiovascular disease (primary prevention), higher CAVI was associated with first-time CVEs (high vs normal: HR: 1.60 [95% CI: 1.15-2.21]; P = 0.005; I2 = 65%; HR per SD/unit increase: 1.28 [95% CI: 1.12-1.47]; P < 0.001; I2 = 18%). There was no association between CAVI and mortality (HR = 1.31 [0.92-1.87]; P = 0.130; I2 = 53%). CAVI was associated with kidney function decline (high vs normal: HR = 1.30 [1.18-1.43]; P < 0.001; I2 = 38%; HR per SD/unit increase: 1.12 [95% CI: 1.07-1.18]; P < 0.001; I2 = 0%).
UNASSIGNED: Higher CAVI is associated with incident CVEs, and this association is present in the primary prevention setting. Elevated CAVI is associated with kidney function decline.