Corrigendum to ‘Association of ANRIL gene polymorphisms with major adverse cardiovascular events in hemodialysis patients’ [Clinica Chimica Acta (2017) 61–67]

Uremia-related inflammation is prone to be a key factor to explain high cardiovascular morbidity in hemodialysis patients. Genetic susceptibility may be of importance, including IL-10, IL-6, and TNF. The aim was to analyze IL-10, IL-6, and TNF gene polymorphisms in a group of hemodialysis patients and to correlate the findings with cardiovascular morbidity. This study included 169 patients on regular hemodialysis at Zvezdara University Medical Center. Gene polymorphisms for IL-10, IL-6 and TNF were determined using PCR. These findings were correlated with the cardiovascular morbidity data from patient histories. Heterozygots for IL-10 gene showed significantly lower incidence of cardiovascular events (p = 0.05) and twice lower risk for development of myocardial infarction, but experienced twice higher risk for left ventricular hypertrophy. Regarding TNF gene polymorphism, patients with A allele had 1.5-fold higher risk for cerebrovascular accident and cardiovascular events and 2-fold higher risk for hypertension and peripheral vascular disease. Patients with G allele of IL-6 gene experienced 1.5-fold higher risks for cerebrovascular accident. We need studies with larger number of patients for definitive conclusion about the influence of gene polymorphisms on cardiovascular morbidity in hemodialysis patients and its importance in everyday clinical practice.

Download Full-text

Heart Rate Variability Predicts Major Adverse Cardiovascular Events and Hospitalization in Maintenance Hemodialysis Patients

Kidney & Blood Pressure Research ◽

10.1159/000469716 ◽

2017 ◽

Vol 42 (1) ◽

pp. 76-88 ◽

Cited By ~ 9

Author(s):

Jiun-Chi Huang ◽

I-Ching Kuo ◽

Yi-Chun Tsai ◽

Jia-Jung Lee ◽

Lee-Moay Lim ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Cardiovascular Events ◽

Hemodialysis Patients ◽

Major Adverse Cardiovascular Events ◽

Maintenance Hemodialysis ◽

Maintenance Hemodialysis Patients

Download Full-text

β-blocker dialyzability and the risk of mortality and cardiovascular events in patients undergoing hemodialysis

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa058 ◽

2020 ◽

Vol 35 (11) ◽

pp. 1959-1965 ◽

Cited By ~ 2

Author(s):

Ping-Hsun Wu ◽

Yi-Ting Lin ◽

Mei-Chuan Kuo ◽

Jia-Sin Liu ◽

Yi-Chun Tsai ◽

...

Keyword(s):

Cardiovascular Events ◽

Hemodialysis Patients ◽

Major Adverse Cardiovascular Events ◽

Coronary Syndrome ◽

Mortality Hazard ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Β Blocker ◽

Mortality Hazard Ratio

Abstract Background β-blocker (BB) dialyzability has been proposed to limit their efficacy among hemodialysis (HD) patients. We attempted to confirm this hypothesis by comparing health outcomes associated with the initiation of dialyzable or nondialyzable BBs in a nationwide cohort of HD patients. Methods We created a prospective cohort study of 15 699 HD patients who initiated dialyzable BBs (atenolol, acebutolol, metoprolol and bisoprolol) and 20 904 hemodialysis patients who initiated nondialyzable BBs (betaxolol, carvedilol and propranolol) between 2004 and 2011 in Taiwan healthcare. We compared the risk of all-cause mortality and major adverse cardiovascular events (MACEs, a composite of the acute coronary syndrome, ischemic stroke and heart failure) between users of dialyzable versus nondialyzable BBs during a 2-year follow-up. Results New users of dialyzable BBs were younger, more often men, with diabetes mellitus, hypertension and hyperlipidemia compared with users of nondialyzable BBs. Compared with nondialyzable BBs, initiation of dialyzable BBs was associated with lower all-cause mortality {hazard ratio [HR] 0.82 [95% confidence interval (CI) 0.75–0.88]} and lower risk of MACEs [HR 0.89 (95% CI 0.84–0.93)]. Results were confirmed in subgroup analyses, censoring at BB discontinuation or switch, after 1:1 propensity score matching, reclassifying bisoprolol or excluding bisoprolol/carvedilol users. Conclusions This study does not offer support for the hypothesis that the dialyzability of BBs reduces their efficacy in HD patients.

Download Full-text

De novo Cardiac Valve Calcification after Hemodialysis in End-Stage Renal Disease Patients Predicts Future Cardiovascular Events: A Longitudinal Cohort Study

Cardiorenal Medicine ◽

10.1159/000494701 ◽

2019 ◽

Vol 9 (4) ◽

pp. 229-239

Author(s):

Fu-Jun Lin ◽

Xi Zhang ◽

Lu-Sheng Huang ◽

Xin Zhou ◽

Gang Ji ◽

...

Keyword(s):

Cardiovascular Events ◽

Cox Regression ◽

De Novo ◽

Hemodialysis Patients ◽

Cardiovascular Outcomes ◽

Cardiac Valve ◽

Major Adverse Cardiovascular Events ◽

Valve Calcification ◽

Increased Risk ◽

Cardiac Valve Calcification

Background: Cardiac valve calcification (CVC) in maintenance hemodialysis patients is associated with adverse cardiovascular outcomes. However, whether de novo CVC in incident hemodialysis patients predicts future cardiovascular events is unknown. Methods: This study included 174 patients newly receiving hemodialysis without CVC as reflected by echocardiography between January 2005 and December 2014. De novo CVC was determined with echocardiography once every 6 months until December 2016. Results: The median follow-up was 66 months (range, 19–141). De novo CVC developed in 80 out of 174 (45.98%) subjects: 58 developed aortic valve calcification (AVC) alone, 42 developed mitral valve calcification (MVC) alone, and 20 developed both AVC and MVC. The median time from baseline to de novo CVC was 46 months (range, 3–120) for AVC and 50 months (range, 13–127) for MVC. Patients who developed CVC had a higher major adverse cardiovascular events (MACE) rate than those who did not (AVC: 30/58 [51.72%] vs. 23/116 [19.83%]; MVC: 25/42 [59.52%] vs. 28/132 [21.21%]). Multivariate time-dependent Cox regression showed an association between MACE with both de novo AVC and MVC (AVC: hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.55–6.63; MVC: HR 5.95, 95% CI 2.90–12.20). Conclusions: De novo CVC is an independent risk factor for MACE in hemodialysis patients, and regular CVC screening among hemodialysis patients without preexisting CVC may be helpful to identify patients at increased risk of adverse cardiovascular outcomes.

Download Full-text

Polymorphisms -455G/A and -148C/T and Fibrinogen Plasmatic Level as Risk Markers of Coronary Disease and Major Adverse Cardiovascular Events

Disease Markers ◽

10.1155/2019/5769514 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Luis Miguel Canseco-Avila ◽

Alexander Lopez-Roblero ◽

Eleazar Serrano-Guzman ◽

Javier Aguilar-Fuentes ◽

Carlos Jerjes-Sanchez ◽

...

Keyword(s):

Coronary Disease ◽

Gene Polymorphisms ◽

Cardiovascular Events ◽

Genetic Load ◽

Coronary Event ◽

Plasma Fibrinogen ◽

Major Adverse Cardiovascular Events ◽

Coronary Diseases ◽

Plasmatic Level

Some polymorphisms in genes codifying for fibrinogen have been correlated with plasma levels of this protein, and several studies reported their associations with acute cardiovascular events. In the present study, 118 subjects with unstable and stable coronary diseases were enrolled to determinate the associations among fibrinogen gene polymorphisms, plasma fibrinogen levels, and major cardiovascular adverse events in a sample of southwestern Mexico. The groups, including 81 control subjects, were matched for age, sex, body mass index, and sedentarism. Plasma fibrinogen levels and the polymorphisms 455G/A, -148C/T, +1689T/G, andBclI of the gene of fibrinogen were compared in all groups. Plasma fibrinogen levels (>465 mg/dl) were significant in patients with coronary disease.Fibrinogen plasma values>450 mg/dlwere associated with cardiovascular mortality during the follow-up analysis of the unstable coronary disease group (p=0.04). The allelic loads of -455A and -148T were associated withplasma fibrinogen levels>450 mg/dl(p<0.003andp=0.03, respectively) and with coronary disease (p=0.016andp<0.006, respectively). The follow-up of posterior events after an acute coronary event showed that the genetic load of the -148T allele was associated with major adverse cardiovascular events (RR=1.8,95%CI=1.01‐3.35,p=0.04).Fibrinogen plasmatic levels>450 mg/dland the fibrinogen polymorphisms -455G/A and 148C/T had association with MACE and coronary disease. This study suggests that these gene polymorphisms are associated with cardiovascular risk.

Download Full-text

P0948ASSOCIATION OF PHASE ANGLE WITH NUTRITION, MORTALITY, MAJOR ADVERSE CARDIOVASCULAR EVENTS AND SARCOPENIA IN MAINTENANCE HEMODIALYSIS PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0948 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Eunjin Bae ◽

Tae Won Lee ◽

Ha Nee Jang ◽

Hyun Seop Cho ◽

Hyun-Jung Kim ◽

...

Keyword(s):

Nutritional Status ◽

Phase Angle ◽

Cardiovascular Events ◽

Hemodialysis Patients ◽

Major Adverse Cardiovascular Events ◽

Maintenance Hemodialysis ◽

Lower Phase ◽

All Cause Mortality ◽

History Of ◽

Maintenance Hemodialysis Patients

Abstract Background and Aims Nutrition has been consistently important in end stage renal disease patients. However, it is difficult to obtain adequate nutritional status while avoiding fluid overload, hyperphosphatemia and hyperkalemia in hemodialysis patients. In addition, there is no golden standard for diagnosing protein energy wasting (PEW) in maintenance hemodialysis patients. We studied the clinical significance of phase angle using bioelectrical impedance analysis (BIA), one of the PEW diagnostic tools, to predict various clinical outcomes in maintenance hemodialysis patients. Method We retrospectively enrolled patients who received hemodialysis for more than 3 months from 2016 to March 2019, excluding patients had active cancer, or died within 30 days, had no BIA data. We evaluated the factors related phase angle and the role of phase angle as predictors of all-cause mortality and major adverse cardiovascular events (MACE), sarcopenia. Results Of 191 patients, 63.4% were men, mean age was 64.2 ± 12.4 years, mean body mass index (BMI) was 23.8 ± 6.9 kg/m2, and the most common underlying disease were hypertension and diabetes mellitus. Lower phase angle group (phase angle ≤4°) patients had older age, higher portion of women, malnourished, and history of coronary artery disease (CAD) than higher phase angle group (phase angle >4°) patients. Phase was significantly related with nutritional parameters. During a median follow up of 16.7 months, 14.1% (n=27) patients experienced a MACE, 11.0% (n=21) patients died. In multivariate Cox analyses, lower phase angle, higher CRP level and history of CAD were significantly related with all-cause mortality even after adjustment for covariates. However, phase angle was not significantly associated with MACE and sarcopenia. Conclusion In maintenance hemodialysis patients, phase angle was significantly related to mortality as well as nutritional status, but MACE and sarcopenia were not. Clinicians should be careful to find and treat correctable factors with low phase angle and high CRP level in maintenance hemodialysis patients.

Download Full-text