TY - JOUR
T1 - Impact of multivascular disease on cardiovascular mortality and morbidity in patients receiving hemodialysis
T2 - Ten-year outcomes of the Q-cohort study
AU - Tanaka, Shigeru
AU - Nakano, Toshiaki
AU - Hiyamuta, Hiroto
AU - Taniguchi, Masatomo
AU - Tokumoto, Masanori
AU - Masutani, Kosuke
AU - Ooboshi, Hiroaki
AU - Tsuruya, Kazuhiko
AU - Kitazono, Takanari
N1 - Funding Information:
The authors would like to express their appreciation to the following investigators at the participating institutions: We thank the participants in the Q-cohort study, members of the Society for the Study of Kidney Disease, and all personnel at participating institutions involved in the study. The following personnel (institution) participated in the study: Takashi Ando (Hakozaki Park Internal Medicine Clinic), Takashi Ariyoshi (Ariyoshi Clinic), Koichiro Goto (Goto Clinic), Fumitada Hattori (Nagao Hospital), Harumichi Higashi (St. Mary’s Hospital), Tadashi Hirano (Hakujyuji Hospital), Kei Hori (Munakata Medical Association Hospital), Takashi Inenaga (Eki-saikai Moji Hospital), Hidetoshi Kanai (Kokura Memorial Hospital), Shigemi Kiyama (Kiyama Naika), Tetsuo Komota (Komota Clinic), Hiromasa Kuma (Kuma Clinic), Toshiro Maeda (Kozenkai– Maeda Hospital), Junichi Makino (Makino Clinic), Dai Matsuo (Hirao Clinic), Chiaki Miishima (Miishima Naika Clinic), Koji Mitsuiki (Japanese Red Cross Fukuoka Hospital), Kenichi Motomura (Moto-mura Naika Clinic), Sadatoshi Nakamura and Hidetoshi Nakamura (Kokura Daiichi Hospital), Koi-chi Nakashima (Ohashi Internal Circulatory Clinic), Nobumitsu Okita (Shiroishi Kyoritsu Hospital), Shin-ichiro Osato (Osato Jin Clinic), Sakura Sakamoto (Fujiyamato Spa Hospital), Keiko Shigematsu (Shige-matsu Clinic), Kazumasa Shimamatsu (Shimamatsu Naika Iin), Yoshito Shogakiuchi (Shin-Ai Clinic), Hiroaki Takamura (Hara Hospital), Kazuhito Takeda (Iizuka Hospital), Asuka Terai (Chidoribashi Hospital), Hideyoshi Tanaka (Mojiko-Jin Clinic), Suguru Tomooka (Hakozaki Park Internal Medicine Clinic), Jiro Toyonaga (Fukuoka Renal Clinic), Hiroshi Tsu-ruta (Steel Memorial Yawata Hospital), Ryutaro Yamaguchi (Shiseikai Hospital), Taihei Yanagida (Saiseikai Yahata General Hospital), Tetsuro Yanase (Yanase Internal Medicine Clinic), Tetsuhiko Yoshida (Hamanomachi Hospital), Takahiro Yoshimitsu (Gofukumachi Kidney Clinic, Harasanshin Hospital), and Koji Yoshitomi (Yoshitomi Medical Clinic). We thank Jane Charbonneau, DVM, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. This study was supported by the Kidney Foundation (H19 JKFB 07-13, H20 JKFB 08-8, H23
Publisher Copyright:
© 2021 Japan Atherosclerosis Society.
PY - 2021
Y1 - 2021
N2 - Aim: Multivascular disease, indicating concurrent arteriosclerotic lesions in a number of different vascular beds, is an independent risk factor for recurrent ischemic events in the general population. However, the impact of multivascular disease on the risk of developing cardiovascular disease has not been fully evaluated in patients receiving hemodialysis. Methods: A total of 3,504 hemodialysis patients were prospectively followed for 10 years. In this study, multivascular disease was defined as the coexistence of coronary artery disease and stroke. We examined the relationship between multivascular disease and the occurrence of composite cardiovascular endpoint, consisting of cardiovascular death, nonfatal coronary artery disease, nonfatal stroke, and peripheral artery disease. Results: The proportion of participants with multivascular disease was 5.7% (n=200) at baseline. During follow-up (median, 106.6 months; interquartile range, 50.1–121.8 months), 1,311 patients experienced the composite endpoint, which was defined as at least one of the following: Cardiovascular death (n= 620), nonfatal coronary artery disease (n= 318), nonfatal stroke (n=340), and peripheral artery disease (n=257). Compared with the group with no history of cardiovascular disease, the risk of experiencing the composite endpoint increased significantly with higher numbers of injured vascular beds in patients with single vascular disease (hazard ratio, 1.68; 95% confidence interval, 1.49–1.89) and in those with multivascular disease (hazard ratio, 2.11; 95% confidence interval, 1.71–2.60). In a multivariable analysis, multivascular disease was an independent predictor of cardiovascular events, in addition to diabetes, aging, and hypertension. Conclusions: This study clearly demonstrated that multivascular disease was a powerful predictor for cardiovascular mortality and morbidity in patients receiving hemodialysis.
AB - Aim: Multivascular disease, indicating concurrent arteriosclerotic lesions in a number of different vascular beds, is an independent risk factor for recurrent ischemic events in the general population. However, the impact of multivascular disease on the risk of developing cardiovascular disease has not been fully evaluated in patients receiving hemodialysis. Methods: A total of 3,504 hemodialysis patients were prospectively followed for 10 years. In this study, multivascular disease was defined as the coexistence of coronary artery disease and stroke. We examined the relationship between multivascular disease and the occurrence of composite cardiovascular endpoint, consisting of cardiovascular death, nonfatal coronary artery disease, nonfatal stroke, and peripheral artery disease. Results: The proportion of participants with multivascular disease was 5.7% (n=200) at baseline. During follow-up (median, 106.6 months; interquartile range, 50.1–121.8 months), 1,311 patients experienced the composite endpoint, which was defined as at least one of the following: Cardiovascular death (n= 620), nonfatal coronary artery disease (n= 318), nonfatal stroke (n=340), and peripheral artery disease (n=257). Compared with the group with no history of cardiovascular disease, the risk of experiencing the composite endpoint increased significantly with higher numbers of injured vascular beds in patients with single vascular disease (hazard ratio, 1.68; 95% confidence interval, 1.49–1.89) and in those with multivascular disease (hazard ratio, 2.11; 95% confidence interval, 1.71–2.60). In a multivariable analysis, multivascular disease was an independent predictor of cardiovascular events, in addition to diabetes, aging, and hypertension. Conclusions: This study clearly demonstrated that multivascular disease was a powerful predictor for cardiovascular mortality and morbidity in patients receiving hemodialysis.
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U2 - 10.5551/jat.54098
DO - 10.5551/jat.54098
M3 - Article
C2 - 32684556
AN - SCOPUS:85103682744
SN - 1340-3478
VL - 28
SP - 385
EP - 395
JO - Journal of atherosclerosis and thrombosis
JF - Journal of atherosclerosis and thrombosis
IS - 4
ER -
