Key result
Higher hs-CRP is linked to ~13% greater atherosclerotic risk in hemodialysis patients, unlike lipid disturbances.
Why the study?
Patients on haemodialysis are at high risk for cardiovascular events, but predictors of atherosclerotic events specifically remain unclear.
What are the predictors of atherosclerotic cardiovascular events in patients on regular haemodialysis?
Observational (n=2,773)
What are the predictors of atherosclerotic cardiovascular events in patients on regular haemodialysis?
Answers are grounded in this paper and cite their sources.
In patients on hemodialysis, non-traditional risk factors such as albumin, hs-CRP, and oxidized LDL predict atherosclerotic events, whereas standard LDL cholesterol does not.
Background: Patients on haemodialysis (HD) are at high risk for cardiovascular events, but heart failure and sudden death are more common than atherosclerotic events. The A Study to Evaluate the Use of Rosuvastatinin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events (AURORA) trial was designed to assess the effect of rosuvastatin on myocardial infarction and death from any cardiac cause in 2773 HD patients. We studied predictors of the atherosclerotic cardiovascular events in AURORA. Methods: We readjudicated all deaths and presumed myocardial infarctions according to the criteria used in the Study of Heart and Renal Protection (SHARP); these were specifically developed to separate atherosclerotic from non-atherosclerotic cardiovascular events. The readjudicated atherosclerotic end point included the first event of the following: non-fatal myocardial infarction, fatal coronary heart disease, non-fatal and fatal non-haemorrhagic stroke, coronary revascularization procedures and death from ischaemic limb disease. Stepwise Cox regression analysis was used to identify the predictors of such events. Results: During a mean follow-up of 3.2 years, 506 patients experienced the new composite atherosclerotic outcome. Age, male sex, prevalent diabetes, prior cardiovascular disease, weekly dialysis duration, baseline albumin [hazard ratio (HR) 0.96; 95% confidence interval (CI) 0.94-0.99 per g/L increase], high-sensitivity C-reactive protein (HR 1.13; 95% CI 1.04-1.22 per mg/L increase) and oxidized low-density lipoprotein (LDL) cholesterol (HR 1.09; 95% CI 1.03-1.17 per 10 U/L increase) were selected as significant predictors in the model. Neither LDL cholesterol nor allocation to placebo/rosuvastatin therapy predicted the outcome. Conclusions: Even with the use of strict criteria for end point definition, non-traditional risk factors, but not lipid disturbances, predicted atherosclerotic events in HD patients.
No takes yet. Share an insight, caveat, or question.
Solbu et al. (2016) conducted an observational in Haemodialysis (n=2,773). Non-traditional risk factors (albumin, hs-CRP, oxidized LDL) was evaluated on Composite atherosclerotic outcome (non-fatal myocardial infarction, fatal coronary heart disease, non-fatal and fatal non-haemorrhagic stroke, coronary revascularization procedures and death from ischaemic limb disease) (HR 1.13, 95% CI 1.04-1.22). In haemodialysis patients, non-traditional risk factors such as high-sensitivity C-reactive protein (HR 1.13; 95% CI 1.04-1.22) predicted atherosclerotic events, whereas lipid disturbances did not.
Synapse has enriched 10 related papers. Consider them for comparative context: