Cardio-Ankle Vascular Index Predicts Post-Discharge Stroke in Patients with Heart Failure

Aim: We aimed to evaluate the significance of the cardio-ankle vascular index (CAVI) to predict stroke in patients with heart failure (HF). Methods: This was a prospective observational study, which recruited clinical data from a total of 557 patients who had been hospitalized for HF and undergone CAVI. According to the receiver operating characteristic curve analysis, the accurate cut-off value of CAVI in predicting post-discharge stroke was 9.64. We divided the patients into two groups: the high-CAVI group (HF patients with CAVI ≥ 9.64, n =111, 19.9%) and the low-CAVI group (HF patients with CAVI ＜9.64, n =446, 80.1%). We compared the patients’ characteristics and post-discharge prognosis. The primary endpoint was stroke. Results: The high-CAVI group was older (73.0 vs. 65.5 years old, P ＜0.001). Male sex (73.9% vs. 61.4%, P =0.015), coronary artery disease (47.7% vs. 36.1%, P =0.024), and diabetes mellitus (54.1% vs. 37.4%, P =0.001) were more prevalent in the high-CAVI group. In contrast, there was no difference in left ventricular ejection fraction, and prevalence of hypertension and dyslipidemia. The Kaplan-Meier analysis demonstrated that post-discharge stroke rate was higher in the high-CAVI group than in the low-CAVI group (log-rank P =0.005). In multivariate Cox proportional hazard analysis, high CAVI was found to be an independent predictor of stroke, with an adjusted hazard ratio of 3.599, compared to low CAVI. Conclusion: CAVI independently predicts stroke in patients with HF.