De novo Cardiac Valve Calcification after Hemodialysis in End-Stage Renal Disease Patients Predicts Future Cardiovascular Events: A Longitudinal Cohort Study

Autor:	Xin Zhou, Gengru Jiang, Xi Zhang, Gang Ji, Lu-Sheng Huang, Fujun Lin, Rong Luo, Wei Lu
Rok vydání:	2019
Předmět:	Adult Male medicine.medical_specialty Urology medicine.medical_treatment Heart Valve Diseases 030232 urology & nephrology Kaplan-Meier Estimate 030204 cardiovascular system & hematology End stage renal disease 03 medical and health sciences 0302 clinical medicine Renal Dialysis Risk Factors Internal medicine Cardiac valve calcification medicine Humans Longitudinal Studies Risk factor Aged Proportional Hazards Models Mitral valve calcification business.industry Hazard ratio Calcinosis Middle Aged equipment and supplies Cardiovascular Diseases Aortic Valve Cardiology Kidney Failure Chronic Mitral Valve Female Hemodialysis Aortic valve calcification Cardiology and Cardiovascular Medicine business Mace
Zdroj:	Cardiorenal Medicine. 9:229-239
ISSN:	1664-5502 1664-3828
DOI:	10.1159/000494701
Popis:	Background: Cardiac valve calcification (CVC) in maintenance hemodialysis patients is associated with adverse cardiovascular outcomes. However, whether de novo CVC in incident hemodialysis patients predicts future cardiovascular events is unknown. Methods: This study included 174 patients newly receiving hemodialysis without CVC as reflected by echocardiography between January 2005 and December 2014. De novo CVC was determined with echocardiography once every 6 months until December 2016. Results: The median follow-up was 66 months (range, 19–141). De novo CVC developed in 80 out of 174 (45.98%) subjects: 58 developed aortic valve calcification (AVC) alone, 42 developed mitral valve calcification (MVC) alone, and 20 developed both AVC and MVC. The median time from baseline to de novo CVC was 46 months (range, 3–120) for AVC and 50 months (range, 13–127) for MVC. Patients who developed CVC had a higher major adverse cardiovascular events (MACE) rate than those who did not (AVC: 30/58 [51.72%] vs. 23/116 [19.83%]; MVC: 25/42 [59.52%] vs. 28/132 [21.21%]). Multivariate time-dependent Cox regression showed an association between MACE with both de novo AVC and MVC (AVC: hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.55–6.63; MVC: HR 5.95, 95% CI 2.90–12.20). Conclusions: De novo CVC is an independent risk factor for MACE in hemodialysis patients, and regular CVC screening among hemodialysis patients without preexisting CVC may be helpful to identify patients at increased risk of adverse cardiovascular outcomes.
Databáze:	OpenAIRE
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