Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study.
To evaluate the predictive value of carotid atherosclerotic disease (CAD) and intima-media thickness (IMT) on incident cardiovascular disease and mortality in hemodialysis patients.Multicenter, observational, prospective study including 110 patients, followed-up to 6 years. Carotid doppler ultrasono...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4452075?pdf=render |
| _version_ | 1811263645419569152 |
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| author | Sílvia Collado Elisabeth Coll Carlos Nicolau Mercedes Pons Josep M Cruzado Julio Pascual Aleix Cases |
| author_facet | Sílvia Collado Elisabeth Coll Carlos Nicolau Mercedes Pons Josep M Cruzado Julio Pascual Aleix Cases |
| author_sort | Sílvia Collado |
| collection | DOAJ |
| description | To evaluate the predictive value of carotid atherosclerotic disease (CAD) and intima-media thickness (IMT) on incident cardiovascular disease and mortality in hemodialysis patients.Multicenter, observational, prospective study including 110 patients, followed-up to 6 years. Carotid doppler ultrasonographic findings were classified in 4 degrees of severity: 1) IMT <0.9 mm, 2) IMT >0.9 mm, 3) carotid plaque with stenosis <50% and 4) plaque with stenosis >50%. The associations between IMT and CAD and cardiovascular events, total and cardiovascular mortality were assessed.83% of the patients had atherosclerotic plaques (CAD degrees 3-4). During follow-up, 29.1% of patients experienced cardiovascular events, and 28.2% died, 38.7% of cardiovascular origin. The presence of plaques was associated with cardiovascular events (p = 0.03) while calcified plaques were associated with both cardiovascular events (p = 0.01), cardiovascular mortality (p = 0.03) and non-significantly with overall mortality (p = 0.08) in the survival analysis. Carotid IMT was not associated with outcomes. Cardiovascular events correlated with CAD severity (HR 2.27, 95% CI 1.13-4.54), age (HR 1.04, 1.01-1.06), previous cardiovascular disease (HR 1.75, 1.05-4.42), dyslipidemia (HR 2.25, 1.11-4.53), lipoprotein (a) (HR 1.01, 1.00-1.02), troponin I (HR 3.89, 1.07-14.18), fibrinogen levels (HR 1.38, 0.98-1.94) and antiplatelet therapy (HR 2.14, 1.04-4.4). In an age-adjusted multivariate model, cardiovascular events were independently associated with previous coronary artery disease (HR 3.29, 1.52-7.15) and lipoprotein (a) (HR 1.01, 1.00-1.02).The presence of carotid plaques and, especially, calcified plaques, are predictors of new cardiovascular events and cardiovascular mortality in hemodialysis patients, while IMT was not. The prognostic value of calcified plaques should be confirmed in future studies. |
| first_indexed | 2024-04-12T19:49:06Z |
| format | Article |
| id | doaj.art-beaa51b61ebd4c14b20ff82eabe32ca6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T19:49:06Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-beaa51b61ebd4c14b20ff82eabe32ca62022-12-22T03:18:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01106e012734410.1371/journal.pone.0127344Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study.Sílvia ColladoElisabeth CollCarlos NicolauMercedes PonsJosep M CruzadoJulio PascualAleix CasesTo evaluate the predictive value of carotid atherosclerotic disease (CAD) and intima-media thickness (IMT) on incident cardiovascular disease and mortality in hemodialysis patients.Multicenter, observational, prospective study including 110 patients, followed-up to 6 years. Carotid doppler ultrasonographic findings were classified in 4 degrees of severity: 1) IMT <0.9 mm, 2) IMT >0.9 mm, 3) carotid plaque with stenosis <50% and 4) plaque with stenosis >50%. The associations between IMT and CAD and cardiovascular events, total and cardiovascular mortality were assessed.83% of the patients had atherosclerotic plaques (CAD degrees 3-4). During follow-up, 29.1% of patients experienced cardiovascular events, and 28.2% died, 38.7% of cardiovascular origin. The presence of plaques was associated with cardiovascular events (p = 0.03) while calcified plaques were associated with both cardiovascular events (p = 0.01), cardiovascular mortality (p = 0.03) and non-significantly with overall mortality (p = 0.08) in the survival analysis. Carotid IMT was not associated with outcomes. Cardiovascular events correlated with CAD severity (HR 2.27, 95% CI 1.13-4.54), age (HR 1.04, 1.01-1.06), previous cardiovascular disease (HR 1.75, 1.05-4.42), dyslipidemia (HR 2.25, 1.11-4.53), lipoprotein (a) (HR 1.01, 1.00-1.02), troponin I (HR 3.89, 1.07-14.18), fibrinogen levels (HR 1.38, 0.98-1.94) and antiplatelet therapy (HR 2.14, 1.04-4.4). In an age-adjusted multivariate model, cardiovascular events were independently associated with previous coronary artery disease (HR 3.29, 1.52-7.15) and lipoprotein (a) (HR 1.01, 1.00-1.02).The presence of carotid plaques and, especially, calcified plaques, are predictors of new cardiovascular events and cardiovascular mortality in hemodialysis patients, while IMT was not. The prognostic value of calcified plaques should be confirmed in future studies.http://europepmc.org/articles/PMC4452075?pdf=render |
| spellingShingle | Sílvia Collado Elisabeth Coll Carlos Nicolau Mercedes Pons Josep M Cruzado Julio Pascual Aleix Cases Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study. PLoS ONE |
| title | Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study. |
| title_full | Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study. |
| title_fullStr | Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study. |
| title_full_unstemmed | Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study. |
| title_short | Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study. |
| title_sort | carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients a prospective study |
| url | http://europepmc.org/articles/PMC4452075?pdf=render |
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