Effect of vitamin D receptor activators on cardiovascular events in patients on hemodialysis-A post hoc analysis of the LANDMARK study
Effect of vitamin D receptor activators on cardiovascular events in patients on hemodialysis-A post hoc analysis of the LANDMARK study
复制标题
维生素 D 受体激活剂对血液透析患者心血管事件的影响——LANDMARK 研究的事后分析
DOI：
10.1111/1744-9987.13954
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发表时间：
2022
期刊：
影响因子：
1.9
通讯作者：
N Uchida
中科院分区：
文献类型：
--
作者：
K Yoshida;T Mizukami;M Fukagawa;T Akizawa;H Morohoshi;T Sambe;A Takeshima;H Ito;H Ogata;N Uchida
维生素D受体激动剂(VDRA)在控制良好的继发性甲状旁腺功能亢进症透析患者中的临床益处尚不清楚。方法这项具有里程碑意义的研究的后期分析调查了VDRA的使用是否与心血管益处有关。使用VDRA的心血管事件的风险比(HR)为0.99(95%可信区间：0.67-1.46；p=0.945)，全因死亡率的风险比(HR)为0.89(95%CI：0.62-1.28；p=0.541)。在经常使用VDRA的患者中，心血管事件的HR为1.12(95%CI：0.67~1.89；p=0.666)，全因死亡率为1.11(95%CI：0.67~1.85；p=0.688)。结论在继发性甲状旁腺功能亢进的透析患者中，使用VDRA并不能降低心血管事件或全因死亡的风险。
IntroductionThe clinical benefit of vitamin D receptor activators (VDRA) in patients with well‐controlled secondary hyperparathyroidism undergoing dialysis remains unclear.MethodsThis post hoc analysis of the LANDMARK study investigates if VDRA use is associated with cardiovascular benefits. Data of 2135 patients undergoing hemodialysis who were at risk for vascular calcification were analyzed using a Cox proportional hazards model with propensity‐score matching.ResultsThe hazard ratio (HR) for VDRA use was 0.99 (95% confidence interval [CI]: 0.67–1.46;p= 0.945) for cardiovascular events and 0.89 (95% CI: 0.62–1.28;p= 0.541) for all‐cause mortality at baseline. Among patients who always used VDRA, the HR was 1.12 (95% CI: 0.67–1.89;p= 0.666) for cardiovascular events and 1.11 (95% CI: 0.67–1.85;p= 0.688) for all‐cause mortality compared to those who never used VDRA.ConclusionThe use of VDRA does not reduce the risks of cardiovascular events or all‐cause mortality in patients on dialysis with well‐controlled secondary hyperparathyroidism.