Abstract
comparative assessment of informativity of parameters of arterial wall stiffness - the cardio-ankle vascular index (CAVI), the augmentation index (AI) - for solution of problems of screening patients being under threat of realization of complex impact of metabolic syndrome (MS) and elevated vessel wall stiffness, both creators and markers of high risk of severe cardiovascular complications. We examined mining industry employees (n=206) with cardiac risk factors (arterial hypertension, abdominal obesity, and smoking). Comparative group comprised 75 employees of the same enterprise without above-mentioned risk factors. Studies of arterial wall stiffness included determination of CAVI and AI. The sensitivity, specifcity and accuracy of the screening method were calculated. CAVI and AI parameters had different sensitivity, specifcity and accuracy for identifying patients at risk of cardiovascular complications. AI was 2 times more sensitive than CAVI during examination of patients with only clinical and anamnestic cardiovascular risk markers and patients with clinical-anamnestic and laboratory risk markers. Specifcity of AI was lower than specifcity of CAVI and atained only 34.4% in patients with clinical-anamnestic and laboratory risk factors. At the same time, specifcity of CAVI in these patients reached 86.2%. Accuracy of AI for screening study was 1.4 times higher than that of CAVI in patients with only clinical-anamnestic risk markers, and 1.6 times higher in patients with both clinical-anamnestic and laboratory risk markers. Moreover, after comparing patient groups with individually high and normal CAVI and AI, we found the differences in metabolic laboratory risk factors (glucose, total cholesterol, triglycerides and the Atherogenic Index) only for AI. Parameters of arterial stiffness have different informative value for screening of patients with clinical-anamnestic or laboratory risk factors. AI compared with CAVI is 2 times more sensitive and 1.6 times more accurate but has lower specifcity for risk factor screening among patients being under threat of realization of complex impact of MS and elevated vessel wall stiffness.
Highlights
Основу борьбы с сердечно-сосудистыми заболеваниями (ССЗ) составляет концепция факторов риска (ФР), которая позволяет выявлять потенциальную угрозу тяжелого сердечно-сосудистого осложнения (ССО) и осуществлять профилактические мероприятия на доклиническом этапе развития ССЗ
After comparing patient groups with individually high and normal cardio-ankle vascular index (CAVI) and augmentation index (AI), we found the differences in metabolic laboratory risk factors only for AI.Conclusion
AI compared with CAVI is 2 times more sensitive and 1.6 times more accurate but has lower specificity for risk factor screening among patients being under threat of realization of complex impact of metabolic syndrome (MS) and elevated vessel wall stiffness
Summary
AI compared with CAVI is 2 times more sensitive and 1.6 times more accurate but has lower specificity for risk factor screening among patients being under threat of realization of complex impact of MS and elevated vessel wall stiffness. Цель исследования: сравнительная оценка информативности показателей ЖАС (CAVI, AI) для решения задач скринингового обследования пациентов c угрозой реализации комплексного воздействия МС и повышения жесткости сосудистой стенки, формирующих и маркирующих риск развития тяжелых ССО. Должные величины CAVI для соответствующего возраста определяли по формуле [7]: CAVI = 5,43 + 0,053 × A (1), где CAVI – сердечно-лодыжечный сосудистый индекс; А – возраст. Должные величины AI для соответствующего возраста определяли по формуле [2]: AI = 0,6 + 0,07 × A (2), где AI – индекс прироста; А – возраст.
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