Key result
Combined ECG and UCG abnormalities linked to ~322% greater CVD risk in advanced CKD.
Why the study?
In patients with chronic kidney disease, cardiovascular disease incidence rises with disease progression, prompting investigation into whether ECG and echocardiography abnormalities are risk factors for CVD.
Do abnormalities in resting electrocardiography and ultrasonic echocardiography predict the occurrence of cardiovascular disease in patients with advanced chronic kidney disease?
Observational (n=604)
No
Do abnormalities in resting electrocardiography and ultrasonic echocardiography predict the occurrence of cardiovascular disease in patients with advanced chronic kidney disease?
In patients with advanced chronic kidney disease, the presence of abnormalities on both resting ECG and UCG is strongly and independently associated with a higher risk of cardiovascular events, highlighting their utility as simple, non-invasive screening tools.
May aid risk stratification in advanced CKD; leaves open whether dual screening improves outcomes.
BACKGROUND: In patients with chronic kidney disease (CKD), the incidence of cardiovascular disease (CVD) increases with disease progression. CVD screening tests in those with CKD were researched to determine whether abnormalities observed in electrocardiography (ECG) and ultrasonic echocardiography (UCG) were risk factors associated with the development of CVD. METHODS: This study included 604 patients with CKD G4 and G5, for whom both ECG and UCG were performed. They were divided into four groups: those without ECG- and UCG-indicated abnormalities (group A, n = 333), with only ECG abnormalities (group B, n = 106), with only UCG abnormalities (group C, n = 75), and with both ECG and UCG abnormalities (group D, n = 90). Multivariate analysis using Cox regression analysis of the occurrence of CVD was performed during a follow-up period. RESULTS: During the observation period, 124 patients had clinical events. Among them, 45 patients (13.5%) were in Group A, 25 patients (23.6%) in Group B, 19 patients (25.3%) in Group C, and 35 patients (38.9%) in Group D, respectively. CVD event occurrence was highest in Group D. The results of the multivariate analysis also showed that the CVD event rates were significantly higher in Group C (HR: 2.96, P = < .001) and D (HR: 4.22, P < .001) than in Group A. CONCLUSION: In patients with advanced CKD, there was a significant correlation of ECG and UCG abnormalities with CVD events. Additionally, those having both types of abnormalities may have a higher risk of coronary artery disease than other groups.
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Hirabayashi et al. (2023) conducted an observational in Advanced chronic kidney disease (stages G4 and G5) (n=604). Abnormalities in both electrocardiography (ECG) and ultrasonic echocardiography (UCG) vs. No ECG or UCG abnormalities was evaluated on Occurrence of cardiovascular disease (CVD) events (HR 4.22, 95% CI 2.426-7.351, p=<0.001). In patients with advanced chronic kidney disease, having both electrocardiography and ultrasonic echocardiography abnormalities significantly increased the risk of cardiovascular disease events compared to having no abnormalities (HR 4.22).
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