Cardiorenal Medicine | |
Calcification of the Aortic Arch Predicts Cardiovascular and All-Cause Mortality in Chronic Hemodialysis Patients | |
Terry Ting-Yu Chiou1  Chiang-Chi Huang1  Wei-Hung Kuo1  Hwee-Yeong Ng1  Chien-Hsing Wu1  Chien-Te Lee1  Chung-Yao Hsu1  Yueh-Ting Lee1  | |
[1] $$ | |
关键词: Vascular calcification; Hemodialysis; Survival; | |
DOI : 10.1159/000360230 | |
来源: S Karger AG | |
【 摘 要 】
Background: Cardiovascular calcification represents a marker of cardiovascular risk in chronic dialysis patients. In the general population, aortic arch calcification (AAC) can predict cardiovascular mortality. We conducted a prospective study to investigate factors associated with AAC in hemodialysis patients and examined its prognostic value in long-term outcome. Methods: A total of 712 hemodialysis patients were enrolled. AAC was identified on postero-anterior chest X-ray films and classified as grade (Gr.) 0, 1, 2 or 3. Demographic data including age, gender, dialysis vintage, co-morbidity and biochemical data were reviewed and recorded. The patients were followed for 10 years. Results: AAC was present in 164 patients (23%) as Gr. 1, in 116 patients (16.3%) as Gr. 2 and in 126 patients (17.7%) as Gr. 3. An increase in the severity of calcification was associated with older patients who had lower albumin, higher calcium and glucose levels. During the follow-up period of 10 years, we found that the grade of AAC was directly related to cardiovascular mortality (Gr. 0: 5.3%; Gr. 1: 12.7%; Gr. 2: 18.9%, and Gr. 3: 24.4%; p < 0.05) and all-cause mortality (Gr. 0: 19.9%; Gr. 1: 31.1%; Gr. 2: 44.8%, and Gr. 3: 53.2%; p < 0.001). Multivariate Cox proportional hazards analysis revealed that high-grade calcification was associated with cardiovascular and all-cause mortality. Patients with AAC were associated with a worse outcome in survival analysis. The severity of AAC also influenced their survival. Conclusion: Calcification of the aortic arch detected in plain chest radiography was an important determinant of cardiovascular as well as all-cause mortality in chronic hemodialysis patients. The presence and severity of AAC predicted long-term survival.
【 授权许可】
Unknown
【 预 览 】
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RO201912040509477ZK.pdf | 422KB | download |