Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/102728
Title: Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: A prospective study
Author: Collado, Sílvia
Coll, Elisabeth
Nicolau, Carlos
Pons, Mercedes
Cruzado, Josep Ma.
Pascual, Julio
Cases Amenós, A. (Aleix)
Keywords: Diàlisi
Aterosclerosi
Malalties coronàries
Estenosi
Malalties del ronyó
Hipertensió
Estudi de casos
Dialysis
Atherosclerosis
Coronary diseases
Stenosis
Kidney diseases
Hypertension
Case studies
Issue Date: 1-Jun-2015
Publisher: Public Library of Science (PLoS)
Abstract: Background To evaluate the predictive value of carotid atherosclerotic disease (CAD) and intima-media thickness (IMT) on incident cardiovascular disease and mortality in hemodialysis patients. Methods 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. Results 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). Conclusions 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.
Note: Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0127344
It is part of: PLoS One, 2015, vol. 10, num. 6, p. e0127344
Related resource: http://dx.doi.org/10.1371/journal.pone.0127344
URI: http://hdl.handle.net/2445/102728
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)

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