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Article: Cardiac valve calcification as an important predictor for all-cause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: A prospective study

TitleCardiac valve calcification as an important predictor for all-cause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: A prospective study
Authors
Issue Date2003
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.org
Citation
Journal Of The American Society Of Nephrology, 2003, v. 14 n. 1, p. 159-168 How to Cite?
AbstractCalcification complications are frequent among longterm dialysis patients. However, the prognostic implication of cardiac valve calcification in this population is not known. This study aimed to determine if cardiac valve calcification predicts mortality in long-term dialysis patients. Baseline echocardiography was performed in 192 patients (mean ± SD age, 55 ± 12 yr) on continuous ambulatory peritoneal dialysis (mean ± SD duration of dialysis, 39 ± 31 mo) to screen for calcification of the aortic valve, mitral valve, or both. Valvular calcification was present in 62 patients. During the mean follow-up of 17.9 mo (range, 0.6 to 33.9 mo), 46 deaths (50% of cardiovascular causes) were observed. Overall 1-yr survival was 70% and 93% for patients with and without valvular calcification (P < 0.0001, log-rank test). Cardiovascular mortality was 22% and 3% for patients with and without valvular calcification (P < 0.0001). Multivariable Cox regression analysis showed that cardiac valve calcification was predictive of an increased all-cause mortality (hazard ratio [HR], 2.50; 95% CI, 1.32 to 4.76; P = 0.005) and cardiovascular death (HR 5.39; 95% CI, 2.16 to 13.48; P = 0.0003) independent of age, male gender, dialysis duration, C-reactive protein, diabetes, and atherosclerotic vascular disease. Eighty-nine percent of patients with both valvular calcification and atherosclerotic vascular disease, 23% of patients with valvular calcification only, 21% of patients with atherosclerotic vascular disease only, and 13% of patients with neither complication died at 1-yr (P < 0.0005). The cardiovascular death rate was 85% for patients with both complications, 13% for patients with valvular calcification only, 14% for patients with atherosclerotic vascular disease only, and 5% for those with neither complication (P < 0.0005). The number of calcified valves was associated with all-cause mortality (P < 0.0005) and cardiovascular death (P < 0.0005). One-year all-cause mortality was 57% for patients with both aortic and mitral valves calcified, 40% for those with either valve calcified, and 15% for those with neither valve calcified. In conclusion, cardiac valve calcification is a powerful predictor for mortality and cardiovascular deaths in long-term dialysis patients. Valvular calcification by itself has similar prognostic importance as the presence of atherosclerotic vascular disease. Its coexistence with other atherosclerotic complications indicates more severe disease and has the worst outcome.
Persistent Identifierhttp://hdl.handle.net/10722/162665
ISSN
2015 Impact Factor: 8.491
2015 SCImago Journal Rankings: 4.699
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorWoo, Jen_US
dc.contributor.authorLam, CWKen_US
dc.contributor.authorLi, PKTen_US
dc.contributor.authorLui, SFen_US
dc.contributor.authorSanderson, JEen_US
dc.date.accessioned2012-09-05T05:22:11Z-
dc.date.available2012-09-05T05:22:11Z-
dc.date.issued2003en_US
dc.identifier.citationJournal Of The American Society Of Nephrology, 2003, v. 14 n. 1, p. 159-168en_US
dc.identifier.issn1046-6673en_US
dc.identifier.urihttp://hdl.handle.net/10722/162665-
dc.description.abstractCalcification complications are frequent among longterm dialysis patients. However, the prognostic implication of cardiac valve calcification in this population is not known. This study aimed to determine if cardiac valve calcification predicts mortality in long-term dialysis patients. Baseline echocardiography was performed in 192 patients (mean ± SD age, 55 ± 12 yr) on continuous ambulatory peritoneal dialysis (mean ± SD duration of dialysis, 39 ± 31 mo) to screen for calcification of the aortic valve, mitral valve, or both. Valvular calcification was present in 62 patients. During the mean follow-up of 17.9 mo (range, 0.6 to 33.9 mo), 46 deaths (50% of cardiovascular causes) were observed. Overall 1-yr survival was 70% and 93% for patients with and without valvular calcification (P < 0.0001, log-rank test). Cardiovascular mortality was 22% and 3% for patients with and without valvular calcification (P < 0.0001). Multivariable Cox regression analysis showed that cardiac valve calcification was predictive of an increased all-cause mortality (hazard ratio [HR], 2.50; 95% CI, 1.32 to 4.76; P = 0.005) and cardiovascular death (HR 5.39; 95% CI, 2.16 to 13.48; P = 0.0003) independent of age, male gender, dialysis duration, C-reactive protein, diabetes, and atherosclerotic vascular disease. Eighty-nine percent of patients with both valvular calcification and atherosclerotic vascular disease, 23% of patients with valvular calcification only, 21% of patients with atherosclerotic vascular disease only, and 13% of patients with neither complication died at 1-yr (P < 0.0005). The cardiovascular death rate was 85% for patients with both complications, 13% for patients with valvular calcification only, 14% for patients with atherosclerotic vascular disease only, and 5% for those with neither complication (P < 0.0005). The number of calcified valves was associated with all-cause mortality (P < 0.0005) and cardiovascular death (P < 0.0005). One-year all-cause mortality was 57% for patients with both aortic and mitral valves calcified, 40% for those with either valve calcified, and 15% for those with neither valve calcified. In conclusion, cardiac valve calcification is a powerful predictor for mortality and cardiovascular deaths in long-term dialysis patients. Valvular calcification by itself has similar prognostic importance as the presence of atherosclerotic vascular disease. Its coexistence with other atherosclerotic complications indicates more severe disease and has the worst outcome.en_US
dc.languageengen_US
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.orgen_US
dc.relation.ispartofJournal of the American Society of Nephrologyen_US
dc.subject.meshAgeden_US
dc.subject.meshArteriosclerosis - Mortalityen_US
dc.subject.meshCalcinosis - Mortality - Ultrasonographyen_US
dc.subject.meshCardiovascular Diseases - Mortalityen_US
dc.subject.meshCause Of Deathen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshEchocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Valve Diseases - Mortality - Ultrasonographyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPeritoneal Dialysisen_US
dc.subject.meshPrognosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshTime Factorsen_US
dc.titleCardiac valve calcification as an important predictor for all-cause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: A prospective studyen_US
dc.typeArticleen_US
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_US
dc.identifier.authorityWang, M=rp00281en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/01.ASN.0000038685.95946.83en_US
dc.identifier.pmid12506148-
dc.identifier.scopuseid_2-s2.0-0037216095en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037216095&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume14en_US
dc.identifier.issue1en_US
dc.identifier.spage159en_US
dc.identifier.epage168en_US
dc.identifier.isiWOS:000180072800017-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWang, AYM=13606226000en_US
dc.identifier.scopusauthoridWang, M=7406690398en_US
dc.identifier.scopusauthoridWoo, J=36040369400en_US
dc.identifier.scopusauthoridLam, CWK=8531362100en_US
dc.identifier.scopusauthoridLi, PKT=25928016800en_US
dc.identifier.scopusauthoridLui, SF=7102379144en_US
dc.identifier.scopusauthoridSanderson, JE=7202371250en_US

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