Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study

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• dc.contributor.author Collado Nieto, Silviaca
• dc.contributor.author Coll, Elisabethca
• dc.contributor.author Nicolau, Carlosca
• dc.contributor.author Pons, Mercedesca
• dc.contributor.author Cruzado, Josep Ma.ca
• dc.contributor.author Pascual Santos, Julioca
• dc.contributor.author Cases Amenós, Aleixca
• dc.date.accessioned 2015-10-01T09:51:36Z
• dc.date.available 2015-10-01T09:51:36Z
• dc.date.issued 2015
• dc.description.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)./nCONCLUSIONS: 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.ca
• dc.description.sponsorship This study was supported in part by the FISS project 03/0791 (a public grant from the Spanish Ministry of Health) ["Fondo de Investigación Sanitaria Instituto Carlos III, Ministerio de Sanidad y Consumo. FIS project 03/0791, http://www.isciii.es/ISCIII/es/contenidos/fd-investigacion/fd-financiacion/convocatorias-ayudas-accion-estrategica-salud.shtml].
• dc.format.mimetype application/pdfca
• dc.identifier.citation Collado S, Coll E, Nicolau C, Pons M, Cruzado JM, Pascual J. et al. Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective study. PLoS One. 2015 Jun 1;10(6):e0127344. doi: 10.1371/journal.pone.0127344.ca
• dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0127344
• dc.identifier.issn 1932-6203
• dc.identifier.uri http://hdl.handle.net/10230/24789
• dc.language.iso engca
• dc.publisher Public Library of Scienceca
• dc.relation.ispartof PLoS One. 2015 Jun 1;10(6):e0127344
• dc.rights © 2015 Collado et al. This is an open access article distributed under the terms of the http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ca
• dc.rights.accessRights info:eu-repo/semantics/openAccessca
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/ca
• dc.subject.other Sistema cardiovascular -- Malaltiesca
• dc.subject.other Hemodiàlisica
• dc.subject.other Aterosclerosica
• dc.title Carotid atherosclerotic disease predicts cardiovascular events in hemodialysis patients: a prospective studyca
• dc.type info:eu-repo/semantics/articleca
• dc.type.version info:eu-repo/semantics/publishedVersionca