CAVI index in patients with vulnerable plaques in the coronary arteries after acute coronary syndrome

Abstract

The aim of the study: to study the relationship between the cardio-ankle index (CAVI) and multispiral computed tomography (CCTA) data of coronary arteries, as well as lipid profile indicators
in patients with acute coronary syndrome.
Materials and methods. In the period from September 2022 to March 2023, 96 patients aged 57.3 (55.4-59.1) years were examined, 67% of them men who were admitted in an emergency with the acute coronary syndrome (ACS) clinic at the V.P. Polyakov SRCCD. All patients underwent percutaneous coronary intervention of the infarct-related artery. Patients received ACS treatment
according to the recommendations, including statin therapy at the maximum dosage. At the 2nd visit, 1 month after ACS, coronary artery CCTA was performed, the CAVI index and lipid profile (TH, LDL, TG, HDL) were evaluated. The CAVI index was determined by the method of volumetric
sphygmography on the VaSera VS-Series Vascular device (Japan). СCTA was performed
on a 128-slice GE Revolution EVO. Vulnerable plaques were evaluated in the Plaque ID program according to the following criteria: positive remodeling, low-density non-calcified plaque (less than 30 HU), spotty calcification in the plaque, the phenomenon of napkin ring sign an uneven contour or a plaque rupture. The calcium index was calculated using the Agatson method.
Results. In the whole group, the value of R-CAVI was 9.3 (8,47-10,2), L-CAVI – 9.3 (8,2-10,3). In women, R-CAVI was 9.25 (8,7-9,93), L-CAVI – 9.25 (8,57-9,60), in men R-CAVI – 9.5 (8,4-10,4), L-CAVI – 9.3 (8,20-10.5). As a result of the correlation analysis, a highly reliable association of R-CAVI, L-CAVI with an increase in age was found (r=0.588, p <0.001 and r=0.619, p <0.001, respectively). The calcium index according to Agatson, calculated according to CCTA of coronary
arteries in the whole group, the calcium index was 58 (11-232) and positively correlated with the value of R-CAVI (r=0.318, p=0.002), L-CAVI (r=0.337, p <0.001). Negative correlations between the CAVI index and the level of low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were also revealed. The relationship between the CAVI index and the presence of vulnerable plaques in the coronary arteries according to CCTA did not entail significant statistical significance (p=0.563).
Conclusion. Arterial stiffness is one of the therapeutic goals to reduce the overall burden of cardiovascular events. We have identified a relationship between the lipid spectrum and the CAVI index, but no correlation with the presence of unstable vulnerable plaques has been established.
Thus, the CAVI index cannot be used as a prognostic marker in the assessment of vulnerable coronary artery plaques.