Relationship between history of coronary heart disease at dialysis initiation and onset of events associated with heart disease

A propensity-matched analysis of a prospective cohort study

Daijo Inaguma, Shigehisa Koide, Kazuo Takahashi, Hiroki Hayashi, Midori Hasegawa, Yukio Yuzawa

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD) events, and a number of reports have shown a relationship between CKD and CVD in pre-dialysis or maintenance dialysis patients. However, few studies have reported serial observations during dialysis initiation and maintenance. Therefore, we examined whether the incidence of heart disease events differed between CKD patients with and without a history of coronary heart disease (CHD) at dialysis initiation. Methods: The subjects were patients in the 17 centers participating in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP) from October 2011 to September 2013. We excluded nine patients whose outcomes were unknown, as determined by a survey conducted at the end of March 2015. Thus, we enrolled 1,515 subjects into the study. We classified patients into 2 groups according to the history of CHD (i.e., a CHD group and a non-CHD group). Propensity scores (PS) represented the probability of being assigned to a group with or without a history of CHD. Onset of heart disease events and associated mortality and all-cause mortality were compared in PS-matched patients by using the log-rank test for Kaplan-Meier curves. Factors contributing to heart disease events were examined using stepwise multivariate Cox proportional hazards analysis. Results: There were 254 patients in each group after PS-matching. During observation, heart disease events occurred in 85 patients (33.5%) in the CHD group and 48 (18.9%) patients in the non-CHD group. The incidence was significantly higher in the CHD group (p < 0.0001). The CHD group was associated with higher incidence of heart disease events (vs. the non-CHD group, hazard ratio = 1.750, 95% confidence interval = 1.160-2.639). In addition, comorbidities such as diabetes mellitus, low body mass index, and low serum high-density lipoprotein cholesterol were associated with higher incidence of events. Conclusion: History of CHD at dialysis initiation was associated with a higher incidence of heart disease events and mortality and all-cause mortality. Trial registration: UMIN 000007096. Registered 18 January 2012.

Original languageEnglish
Article number79
JournalBMC Nephrology
Volume18
Issue number1
DOIs
Publication statusPublished - 28-02-2017

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Coronary Disease
Dialysis
Heart Diseases
Cohort Studies
Prospective Studies
Propensity Score
Chronic Renal Insufficiency
Incidence
Mortality
Cardiovascular Diseases
Maintenance
Kaplan-Meier Estimate
HDL Cholesterol
Comorbidity
Diabetes Mellitus
Body Mass Index
History
Observation
Confidence Intervals
Serum

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

@article{938ca008af7d4569bc7436092c2dc6c2,
title = "Relationship between history of coronary heart disease at dialysis initiation and onset of events associated with heart disease: A propensity-matched analysis of a prospective cohort study",
abstract = "Background: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD) events, and a number of reports have shown a relationship between CKD and CVD in pre-dialysis or maintenance dialysis patients. However, few studies have reported serial observations during dialysis initiation and maintenance. Therefore, we examined whether the incidence of heart disease events differed between CKD patients with and without a history of coronary heart disease (CHD) at dialysis initiation. Methods: The subjects were patients in the 17 centers participating in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP) from October 2011 to September 2013. We excluded nine patients whose outcomes were unknown, as determined by a survey conducted at the end of March 2015. Thus, we enrolled 1,515 subjects into the study. We classified patients into 2 groups according to the history of CHD (i.e., a CHD group and a non-CHD group). Propensity scores (PS) represented the probability of being assigned to a group with or without a history of CHD. Onset of heart disease events and associated mortality and all-cause mortality were compared in PS-matched patients by using the log-rank test for Kaplan-Meier curves. Factors contributing to heart disease events were examined using stepwise multivariate Cox proportional hazards analysis. Results: There were 254 patients in each group after PS-matching. During observation, heart disease events occurred in 85 patients (33.5{\%}) in the CHD group and 48 (18.9{\%}) patients in the non-CHD group. The incidence was significantly higher in the CHD group (p < 0.0001). The CHD group was associated with higher incidence of heart disease events (vs. the non-CHD group, hazard ratio = 1.750, 95{\%} confidence interval = 1.160-2.639). In addition, comorbidities such as diabetes mellitus, low body mass index, and low serum high-density lipoprotein cholesterol were associated with higher incidence of events. Conclusion: History of CHD at dialysis initiation was associated with a higher incidence of heart disease events and mortality and all-cause mortality. Trial registration: UMIN 000007096. Registered 18 January 2012.",
author = "Daijo Inaguma and Shigehisa Koide and Kazuo Takahashi and Hiroki Hayashi and Midori Hasegawa and Yukio Yuzawa",
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doi = "10.1186/s12882-017-0495-8",
language = "English",
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TY - JOUR

T1 - Relationship between history of coronary heart disease at dialysis initiation and onset of events associated with heart disease

T2 - A propensity-matched analysis of a prospective cohort study

AU - Inaguma, Daijo

AU - Koide, Shigehisa

AU - Takahashi, Kazuo

AU - Hayashi, Hiroki

AU - Hasegawa, Midori

AU - Yuzawa, Yukio

PY - 2017/2/28

Y1 - 2017/2/28

N2 - Background: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD) events, and a number of reports have shown a relationship between CKD and CVD in pre-dialysis or maintenance dialysis patients. However, few studies have reported serial observations during dialysis initiation and maintenance. Therefore, we examined whether the incidence of heart disease events differed between CKD patients with and without a history of coronary heart disease (CHD) at dialysis initiation. Methods: The subjects were patients in the 17 centers participating in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP) from October 2011 to September 2013. We excluded nine patients whose outcomes were unknown, as determined by a survey conducted at the end of March 2015. Thus, we enrolled 1,515 subjects into the study. We classified patients into 2 groups according to the history of CHD (i.e., a CHD group and a non-CHD group). Propensity scores (PS) represented the probability of being assigned to a group with or without a history of CHD. Onset of heart disease events and associated mortality and all-cause mortality were compared in PS-matched patients by using the log-rank test for Kaplan-Meier curves. Factors contributing to heart disease events were examined using stepwise multivariate Cox proportional hazards analysis. Results: There were 254 patients in each group after PS-matching. During observation, heart disease events occurred in 85 patients (33.5%) in the CHD group and 48 (18.9%) patients in the non-CHD group. The incidence was significantly higher in the CHD group (p < 0.0001). The CHD group was associated with higher incidence of heart disease events (vs. the non-CHD group, hazard ratio = 1.750, 95% confidence interval = 1.160-2.639). In addition, comorbidities such as diabetes mellitus, low body mass index, and low serum high-density lipoprotein cholesterol were associated with higher incidence of events. Conclusion: History of CHD at dialysis initiation was associated with a higher incidence of heart disease events and mortality and all-cause mortality. Trial registration: UMIN 000007096. Registered 18 January 2012.

AB - Background: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD) events, and a number of reports have shown a relationship between CKD and CVD in pre-dialysis or maintenance dialysis patients. However, few studies have reported serial observations during dialysis initiation and maintenance. Therefore, we examined whether the incidence of heart disease events differed between CKD patients with and without a history of coronary heart disease (CHD) at dialysis initiation. Methods: The subjects were patients in the 17 centers participating in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP) from October 2011 to September 2013. We excluded nine patients whose outcomes were unknown, as determined by a survey conducted at the end of March 2015. Thus, we enrolled 1,515 subjects into the study. We classified patients into 2 groups according to the history of CHD (i.e., a CHD group and a non-CHD group). Propensity scores (PS) represented the probability of being assigned to a group with or without a history of CHD. Onset of heart disease events and associated mortality and all-cause mortality were compared in PS-matched patients by using the log-rank test for Kaplan-Meier curves. Factors contributing to heart disease events were examined using stepwise multivariate Cox proportional hazards analysis. Results: There were 254 patients in each group after PS-matching. During observation, heart disease events occurred in 85 patients (33.5%) in the CHD group and 48 (18.9%) patients in the non-CHD group. The incidence was significantly higher in the CHD group (p < 0.0001). The CHD group was associated with higher incidence of heart disease events (vs. the non-CHD group, hazard ratio = 1.750, 95% confidence interval = 1.160-2.639). In addition, comorbidities such as diabetes mellitus, low body mass index, and low serum high-density lipoprotein cholesterol were associated with higher incidence of events. Conclusion: History of CHD at dialysis initiation was associated with a higher incidence of heart disease events and mortality and all-cause mortality. Trial registration: UMIN 000007096. Registered 18 January 2012.

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