Brachial-Ankle Pulse Wave Velocity and the Cardio-Ankle Vascular Index as a Predictor of Cardiovascular Outcomes in Patients on Regular Hemodialysis
Akihiko Kato,
Takako Takita, Mitsuyoshi Furuhashi, Yukitaka Maruyama, Hiroaki Miyajima,
Hiromichi Kumagai,
Corresponding Author
Akihiko Kato
Blood Purification Unit
Dr Akihiko Kato, Blood Purification Unit, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan. Email: [email protected]Search for more papers by this authorHiroaki Miyajima
Internal Medicine 1, Hamamatsu University School of Medicine
Search for more papers by this authorHiromichi Kumagai
Department of Clinical Nutrition and Sciences, University of Shizouka, Shizuoka, Japan
Search for more papers by this authorAkihiko Kato,
Takako Takita, Mitsuyoshi Furuhashi, Yukitaka Maruyama, Hiroaki Miyajima,
Hiromichi Kumagai,
Corresponding Author
Akihiko Kato
Blood Purification Unit
Dr Akihiko Kato, Blood Purification Unit, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan. Email: [email protected]Search for more papers by this authorHiroaki Miyajima
Internal Medicine 1, Hamamatsu University School of Medicine
Search for more papers by this authorHiromichi Kumagai
Department of Clinical Nutrition and Sciences, University of Shizouka, Shizuoka, Japan
Search for more papers by this authorAbstract
Brachial-ankle pulse wave velocity (baPWV) and the cardio-ankle vascular index (CAVI) are both used to evaluate arterial stiffness. The aim of the present study is to determine whether baPWV or CAVI is superior as a marker of arterial stiffness in hemodialysis (HD) patients. Of 194 patients, 59 patients had been excluded from the study due to advanced age over 76 years old (n = 29), or abnormal ankle-brachial pressure index (ABI) (<0.90 or ≥1.30) (n = 30). We then followed the 135 patients (age: 60 ± 11 years, time on HD: 110 ± 93 months) for the 63 ± 4 (55–70) months. Thirty-two (23.7%) patients had expired, 22 of them of cardiovascular (CV) causes. There were 37 fatal and non-fatal CV events. Kaplan–Meier analysis revealed that the patients with the highest tertile of baPWV (≥16.6 m/s) had a significantly lower survival rate (P < 0.01) when compared with the second (13.4 ≤ baPWV < 16.6 m/s) and the lowest tertiles (<13.4 m/s). Cox hazards analysis after adjustment for comorbid risk factors revealed that the top tertile of baPWV was a determinant of CV death (hazards ratio [HR]: 16.9 [1.1–251.8], P < 0.05) In contrast, CAVI did not associate with CV mortality or events. These findings suggest that baPWV is superior to CAVI as a predictor of CV outcomes in patients on regular HD.
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