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Impact of non-invasive cardiovascular screening programs as a predictor of cardiovascular events among asymptomatic chronic kidney disease patients

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Abstract

Background

The clinical usefulness of physiological and radiological examinations for cardiovascular disease (CVD) risk stratification has not been fully demonstrated in chronic kidney disease (CKD) patients. In the present study, predictive values of CVD were investigated among asymptomatic CKD patients by comprehensive and non-invasive CVD screening programs.

Methods

We prospectively evaluated 139 asymptomatic CKD patients. All patients were examined by comprehensive and non-invasive CVD risk screening programs that included carotid ultrasonography, coronary artery calcification score (CACS), pulse wave velocity, and flow-mediated vasodilation, and their associations with major adverse cardiovascular events (MACEs) were analyzed.

Results

During the median follow-up of 32.3 months, 13 MACEs were observed. Among all CVD screening examinations, severity of the carotid plaque score (PS) and CACS was significantly higher in the MACE group than in the MACE-free group (11.3 ± 5.8 versus 6.1 ± 5.3, P = 0.001 and 657 versus 74, P = 0.020, respectively). Kaplan–Meier curves for the incidences of MACEs classified according to the combination of carotid PS and CACS showed that severe carotid PS and severe CACS groups had the highest event rate in comparison with the groups without any of these (29.9, 11.9, and 3.6 %, respectively, P < 0.001).

Conclusions

In this long-term follow-up analysis, the combination of carotid atherosclerosis and CACS was a useful and non-invasive screening tool for predicting cardiovascular events among asymptomatic CKD patients.

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Acknowledgments

We express our sincere appreciation to all the patients, collaborating physicians, and other medical staff for their important contributions to the study.

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Authors and Affiliations

  1. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Akihiro Sawai, Yoshinari Yasuda, Sawako Kato, Shoichi Maruyama & Seiichi Matsuo

  2. Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshinari Yasuda & Susumu Suzuki

  3. Department of Cardiology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Susumu Suzuki, Hideki Ishii & Toyoaki Murohara

  4. Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Motomitsu Goto & Yutaka Oiso

  5. Department of Cardiology, Fujita Health University Second Hospital, Nagoya, Japan

    Mutsuharu Hayashi

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  1. Akihiro Sawai
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  2. Yoshinari Yasuda
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Correspondence to Susumu Suzuki.

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There is neither a conflict of interest nor financial support in connection with the present study.

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Sawai, A., Yasuda, Y., Suzuki, S. et al. Impact of non-invasive cardiovascular screening programs as a predictor of cardiovascular events among asymptomatic chronic kidney disease patients. Clin Exp Nephrol 20, 416–424 (2016). https://doi.org/10.1007/s10157-015-1169-0

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  • DOI: https://doi.org/10.1007/s10157-015-1169-0

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