A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients
A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients
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DOI：
10.1093/ndt/gfh217
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发表时间：
2004-06-01
影响因子：
6.1
通讯作者：
Negrao, AP
中科院分区：
文献类型：
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作者：
Adragao, T;Pires, A;Negrao, AP
背景心血管疾病的发病率和死亡率在血液透析（HD）患者中非常普遍，最近与血管钙化相关。本研究的目的是评估简单的血管钙化评分对HD患者心血管死亡、心血管住院以及致死性和非致死性心血管事件的预测价值，并将该评分与心血管疾病和其他已知的血管疾病预测因子相关联。在这项观察性、前瞻性研究中，纳入了123例长期HD患者（75例男性和48例女性; 20%为糖尿病患者），这些患者接受了46.6 +/- 52个月（平均值+/- SD）的低通量HD治疗。我们建立了一个简单的血管钙化评分的基础上，骨盆和手的平片。测量肱动脉脉压和平均动脉压（MAP），评估心血管事件和住院事件。在37个月的观察期内，有17例心血管死亡; 28例患者需要心血管住院治疗，32例患者发生致死性和非致死性心血管事件。43例患者（35%）被诊断为冠状动脉疾病，33例患者（26.8%）被诊断为外周动脉疾病，16例患者（13%）被诊断为脑血管疾病，61例患者（49.6%）被诊断为血管疾病（冠状动脉疾病或外周动脉疾病或脑血管疾病）。二元Logistic回归分析显示，糖尿病（P=0.01）、男性（P3. 05）、女性（P4. 05）、男性（P4. 05）、女性（P5. 05）、男性（P5. 05）、女性（P5. 05）该评分>3与冠状动脉疾病（P=0.008）、外周动脉疾病（P3）独立相关，心血管死亡风险增加3.9倍（P=0.03），心血管住院风险增加2.8倍（P=0.02），致命或非致命心血管事件风险增加2.3倍（P=0.04）。目前的血管钙化评分是评估慢性HD患者血管钙化相关心血管风险的简单工具。
Background. Cardiovascular morbidity and mortality are highly prevalent in haemodialysis (HD) patients and have been recently associated with vascular calcifications. The objective of our study was to assess the value of a simple vascular calcification score for the prediction of cardiovascular death, cardiovascular hospitalizations and fatal and non-fatal cardiovascular events in HD patients, and to correlate this score with cardiovascular disease and with other known predictors of vascular disease.Methods. In this observational, prospective study 123 chronic HD patients (75 males and 48 females; 20% diabetic) were included, who were on low-flux HD treatment for 46.6 +/- 52 months (mean +/- SD). We set up a simple vascular calcification score based on plain radiographic films of pelvis and hands. Brachial pulse pressure and mean arterial pressure (MAP) were measured and cardiovascular events and hospitalization episodes were assessed.Results. During an observational period of 37 months there were 17 cardiovascular deaths; 28 patients needed cardiovascular hospitalizations and 32 patients suffered fatal and non-fatal cardiovascular events. Coronary artery disease was diagnosed in 43 patients (35%), peripheral arterial disease in 33 patients (26.8%), cerebrovascular disease in 16 patients (13%) and vascular disease (coronary artery disease or peripheral arterial disease or cerebral vascular disease) in 61 patients (49.6%). By binary logistic regression, diabetes (P=0.01), male sex (P3. This score >3 was independently associated with coronary artery disease (P=0.008), peripheral arterial disease (P3 had a 3.9-fold higher risk of cardiovascular mortality (P=0.03), a 2.8-fold higher risk of cardiovascular hospitalizations (P=0.02) and a 2.3-fold higher risk of fatal or non-fatal cardiovascular events (P=0.04).Conclusions. The present vascular calcification scoring represents a simple tool for the assessment of cardiovascular risk related with vascular calcifications in chronic HD patients.