Cargando…
Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study
Aim: Multivascular disease, indicating concurrent arteriosclerotic lesions in a number of different vascular beds, is an independent risk factor for recurrent ischemic events in the general population. However, the impact of multivascular disease on the risk of developing cardiovascular disease has...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Japan Atherosclerosis Society
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147568/ https://www.ncbi.nlm.nih.gov/pubmed/32684556 http://dx.doi.org/10.5551/jat.54098 |
_version_ | 1783697656905728000 |
---|---|
author | Tanaka, Shigeru Nakano, Toshiaki Hiyamuta, Hiroto Taniguchi, Masatomo Tokumoto, Masanori Masutani, Kosuke Ooboshi, Hiroaki Tsuruya, Kazuhiko Kitazono, Takanari |
author_facet | Tanaka, Shigeru Nakano, Toshiaki Hiyamuta, Hiroto Taniguchi, Masatomo Tokumoto, Masanori Masutani, Kosuke Ooboshi, Hiroaki Tsuruya, Kazuhiko Kitazono, Takanari |
author_sort | Tanaka, Shigeru |
collection | PubMed |
description | Aim: Multivascular disease, indicating concurrent arteriosclerotic lesions in a number of different vascular beds, is an independent risk factor for recurrent ischemic events in the general population. However, the impact of multivascular disease on the risk of developing cardiovascular disease has not been fully evaluated in patients receiving hemodialysis. Methods: A total of 3,504 hemodialysis patients were prospectively followed for 10 years. In this study, multivascular disease was defined as the coexistence of coronary artery disease and stroke. We examined the relationship between multivascular disease and the occurrence of composite cardiovascular endpoint, consisting of cardiovascular death, nonfatal coronary artery disease, nonfatal stroke, and peripheral artery disease. Results: The proportion of participants with multivascular disease was 5.7% (n = 200) at baseline. During follow-up (median, 106.6 months; interquartile range, 50.1–121.8 months), 1,311 patients experienced the composite endpoint, which was defined as at least one of the following: cardiovascular death (n = 620), nonfatal coronary artery disease (n = 318), nonfatal stroke (n = 340), and peripheral artery disease (n = 257). Compared with the group with no history of cardiovascular disease, the risk of experiencing the composite endpoint increased significantly with higher numbers of injured vascular beds in patients with single vascular disease (hazard ratio, 1.68; 95% confidence interval, 1.49–1.89) and in those with multivascular disease (hazard ratio, 2.11; 95% confidence interval, 1.71–2.60). In a multivariable analysis, multivascular disease was an independent predictor of cardiovascular events, in addition to diabetes, aging, and hypertension. Conclusions: This study clearly demonstrated that multivascular disease was a powerful predictor for cardiovascular mortality and morbidity in patients receiving hemodialysis. |
format | Online Article Text |
id | pubmed-8147568 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Japan Atherosclerosis Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-81475682021-05-28 Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study Tanaka, Shigeru Nakano, Toshiaki Hiyamuta, Hiroto Taniguchi, Masatomo Tokumoto, Masanori Masutani, Kosuke Ooboshi, Hiroaki Tsuruya, Kazuhiko Kitazono, Takanari J Atheroscler Thromb Original Article Aim: Multivascular disease, indicating concurrent arteriosclerotic lesions in a number of different vascular beds, is an independent risk factor for recurrent ischemic events in the general population. However, the impact of multivascular disease on the risk of developing cardiovascular disease has not been fully evaluated in patients receiving hemodialysis. Methods: A total of 3,504 hemodialysis patients were prospectively followed for 10 years. In this study, multivascular disease was defined as the coexistence of coronary artery disease and stroke. We examined the relationship between multivascular disease and the occurrence of composite cardiovascular endpoint, consisting of cardiovascular death, nonfatal coronary artery disease, nonfatal stroke, and peripheral artery disease. Results: The proportion of participants with multivascular disease was 5.7% (n = 200) at baseline. During follow-up (median, 106.6 months; interquartile range, 50.1–121.8 months), 1,311 patients experienced the composite endpoint, which was defined as at least one of the following: cardiovascular death (n = 620), nonfatal coronary artery disease (n = 318), nonfatal stroke (n = 340), and peripheral artery disease (n = 257). Compared with the group with no history of cardiovascular disease, the risk of experiencing the composite endpoint increased significantly with higher numbers of injured vascular beds in patients with single vascular disease (hazard ratio, 1.68; 95% confidence interval, 1.49–1.89) and in those with multivascular disease (hazard ratio, 2.11; 95% confidence interval, 1.71–2.60). In a multivariable analysis, multivascular disease was an independent predictor of cardiovascular events, in addition to diabetes, aging, and hypertension. Conclusions: This study clearly demonstrated that multivascular disease was a powerful predictor for cardiovascular mortality and morbidity in patients receiving hemodialysis. Japan Atherosclerosis Society 2021-04-01 /pmc/articles/PMC8147568/ /pubmed/32684556 http://dx.doi.org/10.5551/jat.54098 Text en 2021 Japan Atherosclerosis Society https://creativecommons.org/licenses/by-nc-sa/3.0/This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.http://creativecommons.org/licenses/by-nc-sa/3.0/ (https://creativecommons.org/licenses/by-nc-sa/3.0/) |
spellingShingle | Original Article Tanaka, Shigeru Nakano, Toshiaki Hiyamuta, Hiroto Taniguchi, Masatomo Tokumoto, Masanori Masutani, Kosuke Ooboshi, Hiroaki Tsuruya, Kazuhiko Kitazono, Takanari Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study |
title | Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study |
title_full | Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study |
title_fullStr | Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study |
title_full_unstemmed | Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study |
title_short | Impact of Multivascular Disease on Cardiovascular Mortality and Morbidity in Patients Receiving Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study |
title_sort | impact of multivascular disease on cardiovascular mortality and morbidity in patients receiving hemodialysis: ten-year outcomes of the q-cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147568/ https://www.ncbi.nlm.nih.gov/pubmed/32684556 http://dx.doi.org/10.5551/jat.54098 |
work_keys_str_mv | AT tanakashigeru impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT nakanotoshiaki impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT hiyamutahiroto impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT taniguchimasatomo impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT tokumotomasanori impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT masutanikosuke impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT ooboshihiroaki impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT tsuruyakazuhiko impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy AT kitazonotakanari impactofmultivasculardiseaseoncardiovascularmortalityandmorbidityinpatientsreceivinghemodialysistenyearoutcomesoftheqcohortstudy |