AKI and Long-Term Risk for Cardiovascular Events and Mortality
AKI and Long-Term Risk for Cardiovascular Events and Mortality
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DOI：
10.1681/asn.2016010105
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发表时间：
2017-01-01
影响因子：
13.6
通讯作者：
Hunn, Benjamin H.
中科院分区：
文献类型：
--
作者：
Odutayo, Ayodele;Wong, Christopher X.;Hunn, Benjamin H.
阿基与长期死亡风险增加有关，但阿基在长期心血管疾病方面的预后意义尚未得到证实。我们进行了系统回顾和Meta分析，以评估阿基是否与长期心血管疾病相关。我们纳入了队列研究，这些研究检查了有和没有阿基的成年人，并报告了阿基与心血管死亡率、主要心血管事件和疾病特异性事件（充血性心力衰竭、急性心肌梗死和卒中）之间相关性的多变量调整相对风险（RR）。纳入了25项研究，涉及254，408名成人（55，150名阿基患者）。阿基与心血管死亡率和主要心血管事件风险分别增加86%和38%相关（[RR 1.86; 95%置信区间（95% CI），1.72 - 2.01]和[RR 1.38; 95% CI，1.23 - 1.55]）。对于疾病特异性事件，阿基与心力衰竭风险增加58%（RR 1.58; 95% CI，1.46 - 1.72）和急性心肌梗死风险增加40%（RR 1.40; 95% CI，1.23 - 1.59）相关。在基于阿基严重程度和基线缺血性心脏病成人比例的亚组分析中，心力衰竭和急性心肌梗死的风险升高持续存在。最后，阿基与卒中风险增加15%相关（RR 1.15; 95% CI，1.03 - 1.28）。总之，阿基与心血管死亡率和主要心血管事件（特别是心力衰竭和急性心肌梗死）风险升高相关。
AKI associates with increased long-term risk of mortality, but the prognostic significance of AKI in terms of long-term cardiovascular disease remains unconfirmed. We conducted a systematic review and meta analysis to assess whether AKI associates with long-term cardiovascular disease. We included cohort studies that examined adults with and without AKI and reported a multivariable-adjusted relative risk (RR) for the association between AKI and cardiovascular mortality, major cardiovascular events, and disease specific events: congestive heart failure, acute myocardial infarction, and stroke. Twenty-five studies involving 254,408 adults (55,150 with AKI) were included. AKI associated with an 86% and a 38% increased risk of cardiovascular mortality and major cardiovascular events, respectively ([RR 1.86; 95% confidence interval (95% CI), 1.72 to 2.01] and [RR 1.38; 95% CI, 1.23 to 1.55], respectively). For disease-specific events, AKI associated with a 58% increased risk of heart failure (RR 1.58; 95% CI, 1.46 to 1.72) and a 40% increased risk of acute myocardial infarction (RR 1.40; 95% CI, 1.23 to 1.59). The elevated risk of heart failure and acute myocardial infarction persisted in subgroup analyses on the basis of AKI severity and the proportion of adults with baseline ischemic heart disease. Finally, AKI was associated with a 15% increased risk of stroke (RR 1.15; 95% CI, 1.03 to 1.28). In conclusion, AKI associates with an elevated risk of cardiovascular mortality and major cardiovascular events, particularly heart failure and acute myocardial infarction.