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Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease
Background: Intima-Media-Thickness of the carotid artery wall (cIMT) is a strong predictor of cardiovascular (CV) disease. The aim of this study was to investigate the significance of cIMT as an independent prognostic factor for CV morbidity and mortality in patients with chronic kidney disease (CKD...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442115/ https://www.ncbi.nlm.nih.gov/pubmed/30909780 http://dx.doi.org/10.1080/0886022X.2019.1585372 |
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author | Roumeliotis, Athanasios Roumeliotis, Stefanos Panagoutsos, Stylianos Theodoridis, Marios Argyriou, Christos Tavridou, Anna Georgiadis, George S. |
author_facet | Roumeliotis, Athanasios Roumeliotis, Stefanos Panagoutsos, Stylianos Theodoridis, Marios Argyriou, Christos Tavridou, Anna Georgiadis, George S. |
author_sort | Roumeliotis, Athanasios |
collection | PubMed |
description | Background: Intima-Media-Thickness of the carotid artery wall (cIMT) is a strong predictor of cardiovascular (CV) disease. The aim of this study was to investigate the significance of cIMT as an independent prognostic factor for CV morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes mellitus type 2 (DM2). Methods: The study included 142 diabetic patients in different stages of CKD. Patients were categorized into two groups according to low (≤0.86 mm) or high cIMT (>0.86 mm), respectively. CV events and death from all causes were registered during a seven-year follow-up. Results: Mean age, BMI and duration of diabetes were 68 years (range: 45–90), >30 kg/m(2) and 15 years (range: 5–40), respectively. Patients with increased cIMT were older, suffered from a lower estimated glomerular filtration rate (eGFR), peripheral atherosclerosis and plaque presence in either carotid artery. Increased BMI (beta= −0.29, p = .01), lower eGFR (beta = 0.353, p = .003) and male gender (beta= −0.339, p = .005) were found to predict increased cIMT. Predictors of all-cause mortality in Cox proportional hazard models were low eGFR and high cIMT with HR = 0.96 (CI = 0.94–0.98), p < .001 and HR = 2.9 (CI = 1.03–7.99), p = .04, respectively. The risk of future CV event was determined by albuminuria and cIMT with HR = 1 (CI = 1.0–1.0), p < .001 and HR = 2.04 (CI = 1.1–3.78), p = .02, respectively. Patients with high cIMT presented significantly higher all-cause mortality and a new CV event (p = .005/p = .018, respectively). Conclusions: cIMT is a strong and independent predictor of CV morbidity and mortality, and should be considered a valuable tool for the stratification of CV risk in patients with CKD and DM2. |
format | Online Article Text |
id | pubmed-6442115 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-64421152019-04-05 Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease Roumeliotis, Athanasios Roumeliotis, Stefanos Panagoutsos, Stylianos Theodoridis, Marios Argyriou, Christos Tavridou, Anna Georgiadis, George S. Ren Fail Clinical Study Background: Intima-Media-Thickness of the carotid artery wall (cIMT) is a strong predictor of cardiovascular (CV) disease. The aim of this study was to investigate the significance of cIMT as an independent prognostic factor for CV morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes mellitus type 2 (DM2). Methods: The study included 142 diabetic patients in different stages of CKD. Patients were categorized into two groups according to low (≤0.86 mm) or high cIMT (>0.86 mm), respectively. CV events and death from all causes were registered during a seven-year follow-up. Results: Mean age, BMI and duration of diabetes were 68 years (range: 45–90), >30 kg/m(2) and 15 years (range: 5–40), respectively. Patients with increased cIMT were older, suffered from a lower estimated glomerular filtration rate (eGFR), peripheral atherosclerosis and plaque presence in either carotid artery. Increased BMI (beta= −0.29, p = .01), lower eGFR (beta = 0.353, p = .003) and male gender (beta= −0.339, p = .005) were found to predict increased cIMT. Predictors of all-cause mortality in Cox proportional hazard models were low eGFR and high cIMT with HR = 0.96 (CI = 0.94–0.98), p < .001 and HR = 2.9 (CI = 1.03–7.99), p = .04, respectively. The risk of future CV event was determined by albuminuria and cIMT with HR = 1 (CI = 1.0–1.0), p < .001 and HR = 2.04 (CI = 1.1–3.78), p = .02, respectively. Patients with high cIMT presented significantly higher all-cause mortality and a new CV event (p = .005/p = .018, respectively). Conclusions: cIMT is a strong and independent predictor of CV morbidity and mortality, and should be considered a valuable tool for the stratification of CV risk in patients with CKD and DM2. Taylor & Francis 2019-03-26 /pmc/articles/PMC6442115/ /pubmed/30909780 http://dx.doi.org/10.1080/0886022X.2019.1585372 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Roumeliotis, Athanasios Roumeliotis, Stefanos Panagoutsos, Stylianos Theodoridis, Marios Argyriou, Christos Tavridou, Anna Georgiadis, George S. Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title | Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_full | Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_fullStr | Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_full_unstemmed | Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_short | Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_sort | carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442115/ https://www.ncbi.nlm.nih.gov/pubmed/30909780 http://dx.doi.org/10.1080/0886022X.2019.1585372 |
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