The Existence of Plaque in Carotid Artery Predicts Cardiovascular Death in Patients with End-Stage Renal Disease on Maintenance Hemodialysis.

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Acta Cardiologica Sinica Pub Date : 2025-09-01 DOI:10.6515/ACS.202509_41(5).20250714A

Chieh-Fu Chen, Yu-Sen Peng, Ho-Tsung Hsin

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引用次数: 0

Abstract

Background: Atherosclerosis progresses after starting renal replacement therapy, and it contributes to high cardiovascular mortality. Carotid intima-media thickness (CIMT) and plaque offer a convenient method to explore the status of systemic atherosclerosis. The aim of this cohort study was to determine the significance of carotid plaque and other factors that may impact the clinical outcomes of end-stage renal disease (ESRD) patients.

Methods: Two hundred and sixty-five patients who received maintenance hemodialysis for more than 3 months were enrolled in the study and closely followed for 2 years with clinical events recorded. The primary endpoint was cardiovascular death.

Results: During the 2-year follow-up period, 11.7% of the patients died from cardiovascular causes; however none were caused by stroke. The patients with carotid plaques were older and had thicker left CIMT and right CIMT, lower serum albumin, higher alanine aminotransferase, higher serum glucose, lower serum creatinine, and higher rates of cardiovascular death and overall mortality. Logistic regression analysis showed that the existence of carotid plaque (odds ratio 3.39, 95% confidence interval: 1.577-7.292, p = 0.002) was significantly correlated with the primary outcome. Plaque also significantly impacted overall survival (log-rank p = 0.024).

Conclusions: The presence of carotid plaque was a risk factor for cardiovascular death in patients with ESRD.

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终末期肾病维持性血液透析患者颈动脉斑块的存在预测心血管死亡

背景：动脉粥样硬化在开始肾脏替代治疗后进展，并导致高心血管死亡率。颈动脉内膜-中膜厚度（CIMT）和斑块为探讨系统性动脉粥样硬化状态提供了方便的方法。本队列研究的目的是确定颈动脉斑块和其他可能影响终末期肾病（ESRD）患者临床结局的因素的重要性。方法：选取接受维持性血液透析治疗3个月以上的265例患者，随访2年，记录临床事件。主要终点是心血管死亡。结果：2年随访期间，11.7%的患者死于心血管原因；然而，没有一个是由中风引起的。颈动脉斑块患者年龄较大，左侧和右侧CIMT较厚，血清白蛋白较低，谷丙转氨酶较高，血清葡萄糖较高，血清肌酐较低，心血管死亡率和总死亡率较高。Logistic回归分析显示，颈动脉斑块的存在（优势比3.39,95%可信区间1.577 ~ 7.292,p = 0.002）与主要结局显著相关。斑块也显著影响总体生存（log-rank p = 0.024）。结论：颈动脉斑块的存在是ESRD患者心血管死亡的危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Cardiologica Sinica 医学-心血管系统

CiteScore

2.90

自引率

15.80%

发文量

144

审稿时长

>12 weeks

期刊介绍： Acta Cardiologica Sinica welcomes all the papers in the fields related to cardiovascular medicine including basic research, vascular biology, clinical pharmacology, clinical trial, critical care medicine, coronary artery disease, interventional cardiology, arrythmia and electrophysiology, atherosclerosis, hypertension, cardiomyopathy and heart failure, valvular and structure cardiac disease, pediatric cardiology, cardiovascular surgery, and so on. We received papers from more than 20 countries and areas of the world. Currently, 40% of the papers were submitted to Acta Cardiologica Sinica from Taiwan, 20% from China, and 20% from the other countries and areas in the world. The acceptance rate for publication was around 50% in general.