Prevalence of coronary artery calcification and its association with mortality, cardiovascular events in patients with chronic kidney disease: a systematic review and meta-analysis

Autor: Xing-Xin Xu, Jing-Jing Zhang, Yong-Gui Wu, Xue-Rong Wang
Jazyk: angličtina
Rok vydání: 2019
Předmět:
medicine.medical_specialty
030232 urology & nephrology
Coronary Artery Disease
macromolecular substances
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Risk Assessment
03 medical and health sciences
cardiovascular events
0302 clinical medicine
Risk Factors
cardiovascular mortality
Internal medicine
Prevalence
medicine
Humans
In patient
cardiovascular diseases
Renal Insufficiency
Chronic
Vascular Calcification
business.industry
nutritional and metabolic diseases
General Medicine
Prognosis
medicine.disease
Coronary Vessels
coronary artery calcification
Diseases of the genitourinary system. Urology
Nephrology
Coronary artery calcification
Meta-analysis
Clinical Study
Cardiology
population characteristics
all-cause mortality
RC870-923
business
chronic kidney disease
Kidney disease
Zdroj: Renal Failure, Vol 41, Iss 1, Pp 244-256 (2019)
Renal Failure
ISSN: 1525-6049
Popis: Purpose: To date, the prevalence and prognostic role of coronary artery calcification (CAC) in patients with chronic kidney disease (CKD) have been investigated in several studies, but have yielded conflicting results. The aim of this meta-analysis is to derive a more precise estimation of CAC prevalence in CKD patients and its association with cardiovascular events and mortality. Methods: The relevant literature was identified and evaluated from inception until July 2018 through multiple search strategies on PubMed, Embase, and Web of Science. Cross-sectional or cohort (baseline data) studies reporting CAC prevalence were included. Data extracted from eligible studies were used to calculate effect estimates (ESs) and 95% confidence intervals (95%CI). We searched databases for observational studies that explored baseline CAC and subsequent cardiovascular or all-cause mortality risk in CKD patients. Results: The meta-analysis included 47 studies; 38 of these were included in the final analysis of CAC prevalence. The pooled prevalence of CAC in random effect model was 60% (95%CI 53–68%). CAC was positively associated with an increased risk of all-cause mortality (hazard ratio [HR] 3.44; 95%CI 2.40–4.94), cardiovascular mortality (HR 3.87; 95%CI 2.06–7.26), and cardiovascular events (HR 2.09; 95%CI 1.19–3.67), when comparing individuals in the top CAC score group to those in the bottom CAC score group. Conclusions: The pooled prevalence of CAC is highly prevalent. CAC is independently associated with all-cause and cardiovascular mortality risk as well as cardiovascular events among CKD patients. In view of the high heterogeneity, larger clinical trials are still needed.
Databáze: OpenAIRE
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