Blood Calcification Propensity, Cardiovascular Events, and Survival in Patients Receiving Hemodialysis in the EVOLVE Trial
Blood Calcification Propensity, Cardiovascular Events, and Survival in Patients Receiving Hemodialysis in the EVOLVE Trial
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DOI：
10.2215/cjn.04720416
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发表时间：
2017-02-01
影响因子：
9.8
通讯作者：
Floege, Juergen
中科院分区：
文献类型：
--
作者：
Pasch, Andreas;Block, Geoffrey A.;Floege, Juergen
背景和目的接受血液透析的患者有发生心血管事件的风险。一种新的血液检测方法在参加西那卡塞治疗降低心血管事件的评价（Evaluation of Cinacalcet Therapy to Lower Cardiovascular Events，EVOLVE）试验的接受血液透析的患者的2785个基线血清样本中测定T-50，并且T-50结果与患者结果相关。与T-50正相关/正相关的主要因素是肌酐，负相关/负相关的主要因素是磷酸盐。在中位随访时间619天后，1350例患者达到了主要复合终点（全因死亡率、心肌梗死[MI]、因不稳定型心绞痛住院、心力衰竭或外周血管事件[PVE]）。在调整混杂因素后，作为一个连续的测量指标，较低的T-50与较高的主要复合终点风险独立相关（风险比[HR]/1 SD较低的T-50，1.15; 95%置信区间[95%CI]，1.08 - 1.22; P
Background and objectives Patients receiving hemodialysis are at risk of cardiovascular events. A novel blood test (T-50 test) determines the individual calcification propensity of blood.Design, setting, participants, & measurements T-50 was determined in 2785 baseline serum samples of patients receiving hemodialysis enrolled in the Evaluation of Cinacalcet Therapy to Lower Cardiovascular Events (EVOLVE) trial and the T-50 results were related to patient outcomes.Results Serum albumin, bicarbonate, HDL cholesterol, and creatinine were the main factors positively/directly and phosphate was the main factor negatively/inversely associated with T-50. The primary composite end point (all-cause mortality, myocardial infarction [MI], hospitalization for unstable angina, heart failure, or peripheral vascular event [PVE]) was reached in 1350 patients after a median follow-up time of 619 days. After adjustments for confounding, a lower T-50 was independently associated with a higher risk of the primary composite end point as a continuous measure (hazard ratio [HR] per 1 SD lower T-50, 1.15; 95% confidence interval [95% CI], 1.08 to 1.22; P