BORDERLINE VALUES OF CARDIO-ANKLE VASCULAR INDEX IN PATIENTS WITH ACUTE STROKE: CLINICAL IMPLICATIONS
Abstract
Borderline values of cardio-ankle vascular index (CAVI) in patients with acute stroke: clinical significance. Aim. To study the association between borderline CAVI values and clinical anamnestic and experimental instrumental data in patients with stroke. Material and methods. A total of 284 stroke patients (age 63.1 ± 7.2 years, 183 men and 118 women) have been examined in the neurological department of cardiology clinic. The patients were divided into three groups: I group (n = 81) – patients with CAVI value < 8.0, II group (n = 50) – patients with CAVI value of 8.0–9.0 and III group (n = 153) – patients with CAVI value > 9.0. Groups were composed by basic demographic determinants, presence of risk factors and atherosclerosis prevalence, comorbidity, according to laboratory and instrumental examination data. All patients underwent: a standard neurological examination, brain MSCT, color duplex scanning of brachiocephalic arteries, echocardiography, and laboratory tests (lipidogram, blood chemistry). Results. In stroke patients normal CAVI values were identified in 28.5 % cases, boundary values – in 17.6 % cases, pathological values – in 53.9 % cases. Patients with acute cerebrovascular disorder (ACD) with borderline CAVI values occupy the intermediate position based on the risk factors prevalence compared to patients with normal and abnormal CAVI values. Such factors as: the presence of higher education, angina, heart failure, peripheral atherosclerosis, increase of intima-media thickness (IMT), the presence of brachiocephalic artery (BCA) stenosis, BCA 30–49 % stenosis, decrease of ejection fraction, and increase of total cholesterol content have been more frequently revealed in patients with borderline and abnormal CAVI values. In multiple logistic regression analysis independent predictors abnormal CAVI were IMT increase (OR 2.45; p = 0.04), presence of BCA stenosis (OR = 1.01; p = 0.009), of heart failure (odds ratio OR 2.01; p = 0.02) and absence of higher education (OR 0.4; p = 0.003). Independent predictors of intermediate CAVI were the presence of angina (OR 2.47; p = 0.041) and of BCA stenosis (OR = 1.01; p = 0.037). Conclusion. Assignment of patients with borderline CAVI values is reasonable for dynamic observation of treatment and preventive measures.
Key words
Ott M.V. – junior researcher of laboratory neurovascular pathology of department of the multifocal atherosclerosis, e-mail: daisy1112@mail.ru
