Pulse Pressure and Presence of Coronary Artery Calcification
| Autor: | Domenico Russo, Rosanna Spadola, Stefania Brancaccio, Vittorio E. Andreucci, Paola Napolitano, Massimo Imbriaco, Cinzia Valeria Russo, Luigi Morrone, Ermanno Salvatore |
|---|---|
| Přispěvatelé: | Russo, Domenico, Morrone, L. F., Brancaccio, S., Napolitano, P., Salvatore, E., Spadola, R., Imbriaco, Massimo, Russo, C. V., Andreucci, VITTORIO EMANUELE |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
Time Factors endocrine system diseases Epidemiology medicine.medical_treatment Blood Pressure Coronary Artery Disease Kaplan-Meier Estimate Critical Care and Intensive Care Medicine Severity of Illness Index Coronary artery disease Risk Factors Odds Ratio Calcinosis Middle Aged Prognosis Coronary Calcium Score Pulse pressure Nephrology Predictive value of tests Cardiology cardiovascular system population characteristics Female Kidney Diseases Adult medicine.medical_specialty Aortic Diseases Risk Assessment Disease-Free Survival Predictive Value of Tests Internal medicine medicine Humans cardiovascular diseases Dialysis Aged Retrospective Studies Transplantation Receiver operating characteristic business.industry nutritional and metabolic diseases medicine.disease Surgery Blood pressure ROC Curve Clinical Nephrology Chronic Disease business |
| Popis: | Background: Coronary calcification (CAC) is found in early stages of CKD. Pulse pressure (PP) predicts CAC in dialysis patients. This study evaluates the accuracy of PP in predicting CAC in patients not yet on dialysis (CKD patients). Methods: CKD patients (n 388) underwent coronary calcium score (CAC score) and abdominal x-ray (n 128) for estimating aorta calcification (AAC). Biochemistry and PP were measured every 3 and 6 months in patients with stage 4 to 5 and 2 to 3 CKD, respectively. The accuracy of PP and AAC was assessed by receiver operating characteristics analysis. Results: PP correlated with CAC score in the whole cohort and in patients with stages 2 to 3 and stages 4 to 5 CKD. PP >60 mmHg predicted CAC score >0 (OR: 2.14; P < 0.001), >100 (OR: 2.92; P < 0.001), >400 (OR: 6.17; P < 0.001) after multivariable adjustment. Area under the curve (AUC) was 0.626 for CAC score >0, 0.676 for score >100, and 0.746 for score >400. PP >60 mmHg reduced the rate of event-free survival. AAC was found in 58% of patients and correlated with CAC score. AUC was 0.628 for CAC score >0, 0.652 for score >100, 0.831 for score >400. Conclusion: PP may identify CKD patients with subclinical CAC who need further evaluation. Accuracy of PP and AAC is nearly similar in predicting CAC. High PP indicates vessel wall alterations leading to adverse outcome. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|