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

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...

Full description

Saved in:
Bibliographic Details
Published in:International journal of cardiology 2015-11, Vol.198, p.95-101
Main Authors: Kim, Hyunwook, Kim, Kyoung Hoon, Ahn, Song Vogue, Kang, Shin-Wook, Yoo, Tae-Hyun, Ahn, Hyeong Sik, Hann, Hoo Jae, Lee, Shina, Ryu, Jung-Hwa, Yu, Mina, Kim, Seung-Jung, Kang, Duk-Hee, Choi, Kyu Bok, Ryu, Dong-Ryeol
Format: Article
Language:English
Subjects:
Adult
Aged
Cardiovascular
Cardiovascular disease
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - mortality
Female
Follow-Up Studies
Hemodialysis
Humans
Kidney Failure, Chronic - mortality
Kidney Failure, Chronic - therapy
Male
Middle Aged
Peritoneal dialysis
Peritoneal Dialysis - mortality
Peritoneal Dialysis - trends
Population Surveillance
Registries
Renal Dialysis - mortality
Renal Dialysis - trends
Republic of Korea - epidemiology
Risk Factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2015.06.120