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Association of Ankle-Brachial Index and Aortic Arch Calcification with Overall and Cardiovascular Mortality in Hemodialysis

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ABSTRACT

Peripheral artery occlusive disease and vascular calcification are highly prevalent in hemodialysis (HD) patients, however the association of the combination of ankle-brachial index (ABI) and aortic arch calcification (AoAC) with clinical outcomes in patients undergoing HD is unknown. In this study, we investigated whether the combination of ABI and AoAC is independently associated with overall and cardiovascular mortality in HD patients. The median follow-up period was 5.7 years. Calcification of the aortic arch was assessed by chest X-ray. Forty-seven patients died including 24 due to cardiovascular causes during the follow-up period. The study patients were stratified into four groups according to an ABI < 0.95 or ≥0.95 and an AoAC score of >4 or ≤4 according to receiver operating characteristic curve. Those with an ABI < 0.95 and AoAC > 4 (vs. ABI ≥ 0.95 and AoAC score ≤ 4) were associated with overall (hazard ratio [HR], 4.913; 95% confidence interval [CI], 1.932 to 12.497; p = 0.001) and cardiovascular (HR, 3.531; 95% CI, 1.070 to 11.652; p = 0.038) mortality in multivariable analysis. The combination of a low ABI and increased AoAC was associated with increased overall and cardiovascular mortality in patients undergoing HD.

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Kaplan-Meier analyses of overall survival (log-rank p‚ÄČ<‚ÄČ0.001) among 4 study groups.The group with ABI‚ÄČ<‚ÄČ0.95 and AoAC score‚ÄČ>‚ÄČ4 had a worse overall survival than that with ABI‚ÄČ‚Č•‚ÄČ0.95 and AoAC score‚ÄȂȧ‚ÄČ4.
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f1: Kaplan-Meier analyses of overall survival (log-rank p‚ÄČ<‚ÄČ0.001) among 4 study groups.The group with ABI‚ÄČ<‚ÄČ0.95 and AoAC score‚ÄČ>‚ÄČ4 had a worse overall survival than that with ABI‚ÄČ‚Č•‚ÄČ0.95 and AoAC score‚ÄȂȧ‚ÄČ4.

Mentions: Figure 1 illustrates the Kaplan-Meier survival curves for overall survival among the four study groups. The patients with an ABI‚ÄČ<‚ÄČ0.95 and AoAC score‚ÄČ>‚ÄČ4 had worse overall survival than with an ABI‚ÄČ‚Č•‚ÄČ0.95 and AoAC score‚ÄȂȧ‚ÄČ4 (log-rank test, p‚ÄČ<‚ÄČ0.001).


Association of Ankle-Brachial Index and Aortic Arch Calcification with Overall and Cardiovascular Mortality in Hemodialysis
Kaplan-Meier analyses of overall survival (log-rank p‚ÄČ<‚ÄČ0.001) among 4 study groups.The group with ABI‚ÄČ<‚ÄČ0.95 and AoAC score‚ÄČ>‚ÄČ4 had a worse overall survival than that with ABI‚ÄČ‚Č•‚ÄČ0.95 and AoAC score‚ÄȂȧ‚ÄČ4.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016837&req=5

f1: Kaplan-Meier analyses of overall survival (log-rank p‚ÄČ<‚ÄČ0.001) among 4 study groups.The group with ABI‚ÄČ<‚ÄČ0.95 and AoAC score‚ÄČ>‚ÄČ4 had a worse overall survival than that with ABI‚ÄČ‚Č•‚ÄČ0.95 and AoAC score‚ÄȂȧ‚ÄČ4.
Mentions: Figure 1 illustrates the Kaplan-Meier survival curves for overall survival among the four study groups. The patients with an ABI‚ÄČ<‚ÄČ0.95 and AoAC score‚ÄČ>‚ÄČ4 had worse overall survival than with an ABI‚ÄČ‚Č•‚ÄČ0.95 and AoAC score‚ÄȂȧ‚ÄČ4 (log-rank test, p‚ÄČ<‚ÄČ0.001).

View Article: PubMed Central - PubMed

ABSTRACT

Peripheral artery occlusive disease and vascular calcification are highly prevalent in hemodialysis (HD) patients, however the association of the combination of ankle-brachial index (ABI) and aortic arch calcification (AoAC) with clinical outcomes in patients undergoing HD is unknown. In this study, we investigated whether the combination of ABI and AoAC is independently associated with overall and cardiovascular mortality in HD patients. The median follow-up period was 5.7 years. Calcification of the aortic arch was assessed by chest X-ray. Forty-seven patients died including 24 due to cardiovascular causes during the follow-up period. The study patients were stratified into four groups according to an ABI&thinsp;&lt;&thinsp;0.95 or &ge;0.95 and an AoAC score of &gt;4 or &le;4 according to receiver operating characteristic curve. Those with an ABI&thinsp;&lt;&thinsp;0.95 and AoAC&thinsp;&gt;&thinsp;4 (vs. ABI&thinsp;&ge;&thinsp;0.95 and AoAC score&thinsp;&le;&thinsp;4) were associated with overall (hazard ratio [HR], 4.913; 95% confidence interval [CI], 1.932 to 12.497; p&thinsp;=&thinsp;0.001) and cardiovascular (HR, 3.531; 95% CI, 1.070 to 11.652; p&thinsp;=&thinsp;0.038) mortality in multivariable analysis. The combination of a low ABI and increased AoAC was associated with increased overall and cardiovascular mortality in patients undergoing HD.

No MeSH data available.