CORONARY ARTERY CALCIFICATION SCORE AS A PREDICTOR OF ALL-CAUSE MORTALITY AND CARDIOVASCULAR OUTCOME IN PERITONEAL DIALYSIS PATIENTS
CORONARY ARTERY CALCIFICATION SCORE AS A PREDICTOR OF ALL-CAUSE MORTALITY AND CARDIOVASCULAR OUTCOME IN PERITONEAL DIALYSIS PATIENTS
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DOI：
10.3747/pdi.2014.00124
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发表时间：
2016-03-01
影响因子：
2.8
通讯作者：
Zhu, Tongying
中科院分区：
文献类型：
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作者：
Xie, Qionghong;Ge, Xiaolin;Zhu, Tongying
背景：本研究旨在探讨冠状动脉钙化评分（CaCS）是否与腹膜透析（PD）患者的预后相关。方法：招募临床稳定至少 2 个月的成年 PD 患者参与这项前瞻性观察性队列研究。使用多层螺旋计算机断层扫描评估冠状动脉钙化，并根据 Agatston 评分进行记录。评估的终点包括全因死亡率、心血管事件和心血管死亡率。使用多变量 Cox 回归来确定全因死亡率、心血管事件 (CVE) 和心血管死亡率的独立预测因子。 结果：本研究共招募了 179 名 PD 患者（86 名男性），平均年龄为 63.5 +/- 14.8 岁。冠状动脉钙化评分范围为 0 至 5,257，分层如下：无钙化（CaCS = 0，n = 54）、低钙化（0 < CaCS < 400，n = 72）和高钙化（CaCS = 400，n = 53）。随访时间为 30.6 +/- 16.2 (24 - 63) 个月。与无钙化组相比，CaCS较高的患者年龄较大，舒张压、残余肾功能和血清白蛋白较低，HbA(1)C和血清胰岛素较高。多变量 Cox 回归显示，在 PD 患者中调整后，CaCS 是所有 3 个终点的独立预测因子。结论：CaCS 是腹膜透析患者全因死亡率、心血管事件和心血管死亡率的独立预测因子。
Background: This study aimed to examine whether the coronary artery calcification score (CaCS) was associated with the prognosis of peritoneal dialysis (PD) patients.Methods: Adult PD patients who were clinically stable for at least 2 months were recruited for this prospective, observational cohort study. Coronary artery calcification was assessed using multislice spiral computed tomography and was recorded according to the Agatston score. The endpoints including all-cause mortality, cardiovascular events, and cardiovascular mortality were assessed. Multivariate Cox regression was used to identify independent predictors of all-cause mortality, cardiovascular events (CVEs), and cardiovascular mortality.Results: A total of 179 PD patients (86 men) with a mean age of 63.5 +/- 14.8 years were recruited for this study. Coronary artery calcification scores ranging from 0 to 5,257 were stratified as follows: no (CaCS = 0, n = 54), low (0 < CaCS < 400, n = 72), and high (CaCS = 400, n = 53) calcification. The follow-up duration was 30.6 +/- 16.2 (24 - 63) months. Compared with the no calcification group, patients with a higher CaCS were older and had lower diastolic blood pressure, residual renal function, and serum albumin, and higher HbA(1)C and serum insulin. Multivariate Cox regression revealed that the CaCS was an independent predictor for all the 3 endpoints after adjustment in PD patients.Conclusions: CaCS was an independent predictor of all-cause mortality, cardiovascular events, and cardiovascular mortality in patients receiving peritoneal dialysis.