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Risk of major cardiovascular events among incident dialysis patients: A Korean national population-based study

Title
Risk of major cardiovascular events among incident dialysis patients: A Korean national population-based study
Authors
Kim, HyunwookKim, Kyoung HoonAhn, Song VogueKang, Shin-WookYoo, Tae-HyunAhn, Hyeong SikHann, Hoo JaeLee, ShinaRyu, Jung-HwaYu, MinaKim, Seung-JungKang, Duk-HeeChoi, Kyu BokRyu, Dong-Ryeol
Ewha Authors
한후재강덕희최규복김승정류동열이신아유민아
SCOPUS Author ID
한후재scopus; 강덕희scopus; 최규복scopus; 김승정scopus; 류동열scopus; 이신아scopusscopus; 유민아scopus
Issue Date
2015
Journal Title
INTERNATIONAL JOURNAL OF CARDIOLOGY
ISSN
0167-5273JCR Link1874-1754JCR Link
Citation
vol. 198, pp. 95 - 101
Keywords
HemodialysisPeritoneal dialysisCardiovascular disease
Publisher
ELSEVIER IRELAND LTD
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background: Dialysis patients are at high risk for cardiovascular diseases, but until now there have been no detailed analyses of the incidences among Asian patients initiating dialysis. The aims of this study were to determine the incidence rates of major adverse cardiac and cerebrovascular events (MACCE) and to compare them between incident HD patients and PD patients. Methods: We included all patients who had started dialysis between January 1, 2005 and December 31, 2008 in Korea, and analyzed 30,279 eligible patients [22,892 hemodialysis (HD) patients and 7387 peritoneal dialysis (PD) patients] by intention-to-treat. Median follow-up was 21.5 months. Results: The crude incidence rates were as follows: MACCE, 182 per 1000 patient-years (PY); major adverse cardiac events(MACE), 138/1000 PY; all-cause mortality, 116/1000 PY; non-fatal acute myocardial infarction (AMI), 18/1000 PY; target vessel revascularization (TVR), 17/1000 PY; and non-fatal stroke, 60/1000 PY. When comparing all baseline covariate-adjusted relative risks between HD and PD patients, HD is overall superior to PD in terms of MACCE. Further examined by each endpoint, all-cause mortality, non-fatal AMI, and TVR occurred significantly-more frequently in patients on PD than in those on HD, whereas non-fatal hemorrhagic stroke occurred significantly more frequently in patients on HD than in those on PD. Conclusions: The incidence of MACCE may be different from Western dialysis patients. HD is overall superior to PD in terms of MACCE as an initial dialysis modality. Underlying mechanisms differentially affecting cardiovascular outcomes by dialysis modality remain to be further elucidated. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
DOI
10.1016/j.ijcard.2015.06.120
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의학전문대학원 > 의학과 > Journal papers
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