Combinations of valvular calcification and serum alkaline phosphatase predict cardiovascular risk among end-stage kidney disease patients

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS IJC Heart and Vasculature Pub Date : 2024-09-04 DOI:10.1016/j.ijcha.2024.101505
Chia-Ter Chao , Min-Tser Liao , Chung-Kuan Wu
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Abstract

Background

Valvular calcification (VC) refers to the calcified valvular remodeling associated with kidney dysfunction, especially end-stage kidney disease (ESKD). ESKD patients with VC had significantly higher cardiovascular risk than those without. Factors interacted with VC regarding prognostic prediction in this population were seldom investigated. We aimed to examine the potential synergetic effects of VC and alkaline phosphatase (Alk-P) on ESKD patients’ cardiovascular risk and mortality.

Methods

ESKD patients undergoing hemodialysis were prospectively enrolled from a medical center in 2018. We identified patients with echocardiography and available serum Alk-P levels. Cox proportional hazard regression was performed to analyze the risk of major adverse cardiovascular events (MACEs), cardiovascular and overall mortality among 4 participant groups (with or without VC versus low or high Alk-P levels). The models were further adjusted for age, sex, and clinical variables.

Results

Of the 309 ESKD patients, 38, 46, 112, and 113 had no VC with low Alk-P, no VC with high Alk-P, VC with low Alk-P, and VC with high Alk-P, respectively. After adjusting for age and sex, patients with VC and high Alk-P had a higher risk of developing MACE, cardiovascular and overall mortality (HR, 3.07, 3.67, 3.65; 95% CI 1.38–6.84, 1.1–12.24, 1.29–10.36, respectively). Patients with VC and high Alk-P remained at higher risk of MACE (HR, 2.76; 95% CI 1.17–6.48) than did those without VC and with low Alk-P.

Conclusion

Serum Alk-P could be used to identify a subgroup of ESKD patients with elevated cardiovascular risk among those with VC.

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瓣膜钙化和血清碱性磷酸酶组合可预测终末期肾病患者的心血管风险
背景瓣膜钙化(VC)是指与肾功能障碍,尤其是终末期肾病(ESKD)相关的瓣膜钙化重塑。患有瓣膜钙化的 ESKD 患者的心血管风险明显高于无瓣膜钙化的患者。在这一人群的预后预测方面,与 VC 相互影响的因素很少被研究。我们旨在研究 VC 和碱性磷酸酶(Alk-P)对 ESKD 患者心血管风险和死亡率的潜在协同作用。方法2018 年从一家医疗中心前瞻性地招募了接受血液透析的 ESKD 患者。我们确定了有超声心动图和可用血清 Alk-P 水平的患者。我们进行了 Cox 比例危险回归,以分析 4 组参与者(有或无 VC 与低或高 Alk-P 水平)的主要不良心血管事件(MACE)、心血管和总死亡率的风险。结果 在 309 名 ESKD 患者中,分别有 38 人、46 人、112 人和 113 人无 VC 且低 Alk-P、无 VC 且高 Alk-P、VC 且低 Alk-P 和 VC 且高 Alk-P。调整年龄和性别后,VC 和高 Alk-P 患者发生 MACE、心血管疾病和总死亡率的风险更高(HR,分别为 3.07、3.67、3.65;95% CI,分别为 1.38-6.84、1.1-12.24、1.29-10.36)。结论血清 Alk-P 可用于在 VC 患者中识别心血管风险升高的 ESKD 患者亚群。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
IJC Heart and Vasculature
IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.90
自引率
10.30%
发文量
216
审稿时长
56 days
期刊介绍: IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.
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