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Arterial Calcifications, Arterial Stiffness, and Cardiovascular Risk in End-Stage Renal Disease

To test the predictive values of and independent contributions to cardiovascular and all-cause mortality of various arterial parameters exploring characteristics of the arterial wall at different sites, we studied prospectively 110 stable end-stage renal disease patients on hemodialysis. These param... Full description

Journal Title: Hypertension 2001, Vol.38 (4), p.938-942
Main Author: Blacher, Jacques
Other Authors: Guerin, Alain P , Pannier, Bruno , Marchais, Sylvain J , London, Gerard M
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Philadelphia, PA: Am Heart Assoc
ID: ISSN: 0194-911X
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recordid: cdi_proquest_miscellaneous_72215202
title: Arterial Calcifications, Arterial Stiffness, and Cardiovascular Risk in End-Stage Renal Disease
format: Article
creator:
  • Blacher, Jacques
  • Guerin, Alain P
  • Pannier, Bruno
  • Marchais, Sylvain J
  • London, Gerard M
subjects:
  • Adult
  • Aged
  • Biological and medical sciences
  • Calcinosis - pathology
  • Cardiovascular Diseases - complications
  • Cardiovascular Diseases - pathology
  • Cardiovascular Diseases - physiopathology
  • Carotid Artery Diseases - complications
  • Carotid Artery Diseases - pathology
  • Carotid Artery Diseases - physiopathology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic - complications
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - therapy
  • Male
  • Medical sciences
  • Middle Aged
  • Multivariate Analysis
  • Nephrology. Urinary tract diseases
  • Nephropathies. Renovascular diseases. Renal failure
  • Renal Dialysis
  • Renal failure
  • Risk Factors
  • Severity of Illness Index
  • Survival Analysis
  • Survival Rate
  • Tunica Intima - pathology
ispartof: Hypertension, 2001, Vol.38 (4), p.938-942
description: To test the predictive values of and independent contributions to cardiovascular and all-cause mortality of various arterial parameters exploring characteristics of the arterial wall at different sites, we studied prospectively 110 stable end-stage renal disease patients on hemodialysis. These parameters involved carotid diameter, carotid intima-media thickness, carotid compliance, carotid distensibility, carotid incremental elastic modulus, aortic diameter, aortic pulse wave velocity, and the presence of arterial calcifications measured at the sites of the carotid artery, abdominal aorta, iliofemoral axis, and legs. The presence of calcifications was analyzed semiquantitatively as a score (0 to 4) according to the number of arterial sites with calcifications. During a follow-up of 53+/-21 months (mean+/-SD), 25 cardiovascular and 14 noncardiovascular deaths occurred. In univariate analysis, the carotid incremental elastic modulus was the most closely related to prognosis. Risk of death increased with the number of vascular sites involved by calcifications. Moreover, information (in terms of prediction) given by carotid elastic incremental modulus was additive to the presence and extent of vascular calcification-related prediction value. Adjusted hazard ratios of all-cause and cardiovascular mortality for an increase of 1 unit in calcification score were 1.9 (95% confidence interval [CI], 1.4 to 2.6) and 2.6 (95% CI, 1.5 to 4.4), respectively (P
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleArterial Calcifications, Arterial Stiffness, and Cardiovascular Risk in End-Stage Renal Disease
creatorBlacher, Jacques ; Guerin, Alain P ; Pannier, Bruno ; Marchais, Sylvain J ; London, Gerard M
creatorcontribBlacher, Jacques ; Guerin, Alain P ; Pannier, Bruno ; Marchais, Sylvain J ; London, Gerard M
descriptionTo test the predictive values of and independent contributions to cardiovascular and all-cause mortality of various arterial parameters exploring characteristics of the arterial wall at different sites, we studied prospectively 110 stable end-stage renal disease patients on hemodialysis. These parameters involved carotid diameter, carotid intima-media thickness, carotid compliance, carotid distensibility, carotid incremental elastic modulus, aortic diameter, aortic pulse wave velocity, and the presence of arterial calcifications measured at the sites of the carotid artery, abdominal aorta, iliofemoral axis, and legs. The presence of calcifications was analyzed semiquantitatively as a score (0 to 4) according to the number of arterial sites with calcifications. During a follow-up of 53+/-21 months (mean+/-SD), 25 cardiovascular and 14 noncardiovascular deaths occurred. In univariate analysis, the carotid incremental elastic modulus was the most closely related to prognosis. Risk of death increased with the number of vascular sites involved by calcifications. Moreover, information (in terms of prediction) given by carotid elastic incremental modulus was additive to the presence and extent of vascular calcification-related prediction value. Adjusted hazard ratios of all-cause and cardiovascular mortality for an increase of 1 unit in calcification score were 1.9 (95% confidence interval [CI], 1.4 to 2.6) and 2.6 (95% CI, 1.5 to 4.4), respectively (P<0.001 for both). Adjusted hazard ratios of all-cause and cardiovascular mortality for a 1-SD increase in carotid incremental elastic modulus were 1.6 (95% CI, 1.2 to 2.2) and 1.7 (95% CI, 1.2 to 2.4), respectively (P<0.01 for both). The results of this study showed that the presence and extent of vascular calcifications were strong predictors of cardiovascular and all-cause mortality. Carotid incremental elastic modulus gave additional predictive value.
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subjectAdult ; Aged ; Biological and medical sciences ; Calcinosis - pathology ; Cardiovascular Diseases - complications ; Cardiovascular Diseases - pathology ; Cardiovascular Diseases - physiopathology ; Carotid Artery Diseases - complications ; Carotid Artery Diseases - pathology ; Carotid Artery Diseases - physiopathology ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - therapy ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Renal Dialysis ; Renal failure ; Risk Factors ; Severity of Illness Index ; Survival Analysis ; Survival Rate ; Tunica Intima - pathology
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descriptionTo test the predictive values of and independent contributions to cardiovascular and all-cause mortality of various arterial parameters exploring characteristics of the arterial wall at different sites, we studied prospectively 110 stable end-stage renal disease patients on hemodialysis. These parameters involved carotid diameter, carotid intima-media thickness, carotid compliance, carotid distensibility, carotid incremental elastic modulus, aortic diameter, aortic pulse wave velocity, and the presence of arterial calcifications measured at the sites of the carotid artery, abdominal aorta, iliofemoral axis, and legs. The presence of calcifications was analyzed semiquantitatively as a score (0 to 4) according to the number of arterial sites with calcifications. During a follow-up of 53+/-21 months (mean+/-SD), 25 cardiovascular and 14 noncardiovascular deaths occurred. In univariate analysis, the carotid incremental elastic modulus was the most closely related to prognosis. Risk of death increased with the number of vascular sites involved by calcifications. Moreover, information (in terms of prediction) given by carotid elastic incremental modulus was additive to the presence and extent of vascular calcification-related prediction value. Adjusted hazard ratios of all-cause and cardiovascular mortality for an increase of 1 unit in calcification score were 1.9 (95% confidence interval [CI], 1.4 to 2.6) and 2.6 (95% CI, 1.5 to 4.4), respectively (P<0.001 for both). Adjusted hazard ratios of all-cause and cardiovascular mortality for a 1-SD increase in carotid incremental elastic modulus were 1.6 (95% CI, 1.2 to 2.2) and 1.7 (95% CI, 1.2 to 2.4), respectively (P<0.01 for both). The results of this study showed that the presence and extent of vascular calcifications were strong predictors of cardiovascular and all-cause mortality. Carotid incremental elastic modulus gave additional predictive value.
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21Nephrology. Urinary tract diseases
22Nephropathies. Renovascular diseases. Renal failure
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25Risk Factors
26Severity of Illness Index
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29Tunica Intima - pathology
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abstractTo test the predictive values of and independent contributions to cardiovascular and all-cause mortality of various arterial parameters exploring characteristics of the arterial wall at different sites, we studied prospectively 110 stable end-stage renal disease patients on hemodialysis. These parameters involved carotid diameter, carotid intima-media thickness, carotid compliance, carotid distensibility, carotid incremental elastic modulus, aortic diameter, aortic pulse wave velocity, and the presence of arterial calcifications measured at the sites of the carotid artery, abdominal aorta, iliofemoral axis, and legs. The presence of calcifications was analyzed semiquantitatively as a score (0 to 4) according to the number of arterial sites with calcifications. During a follow-up of 53+/-21 months (mean+/-SD), 25 cardiovascular and 14 noncardiovascular deaths occurred. In univariate analysis, the carotid incremental elastic modulus was the most closely related to prognosis. Risk of death increased with the number of vascular sites involved by calcifications. Moreover, information (in terms of prediction) given by carotid elastic incremental modulus was additive to the presence and extent of vascular calcification-related prediction value. Adjusted hazard ratios of all-cause and cardiovascular mortality for an increase of 1 unit in calcification score were 1.9 (95% confidence interval [CI], 1.4 to 2.6) and 2.6 (95% CI, 1.5 to 4.4), respectively (P<0.001 for both). Adjusted hazard ratios of all-cause and cardiovascular mortality for a 1-SD increase in carotid incremental elastic modulus were 1.6 (95% CI, 1.2 to 2.2) and 1.7 (95% CI, 1.2 to 2.4), respectively (P<0.01 for both). The results of this study showed that the presence and extent of vascular calcifications were strong predictors of cardiovascular and all-cause mortality. Carotid incremental elastic modulus gave additional predictive value.
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