Performance of the Framingham Risk Score in patients receiving hemodialysis

被引:15
作者
Huang, Jiun-Chi [1 ,3 ]
Chen, Szu-Chia [1 ,3 ,5 ]
Su, Ho-Ming [2 ,3 ,5 ]
Chang, Jer-Ming [1 ,3 ,4 ]
Hwang, Shang-Jyh [1 ,4 ]
Chen, Hung-Chun [1 ,4 ]
机构
[1] Kaohsiung Med Univ, Dept Internal Med, Kaohsiung Med Univ Hosp, Div Nephrol, Kaohsiung 812, Taiwan
[2] Kaohsiung Med Univ, Dept Internal Med, Kaohsiung Med Univ Hosp, Div Cardiol, Kaohsiung 812, Taiwan
[3] Kaohsiung Med Univ, Dept Internal Med, Kaohsiung Municipal Hsiao Kang Hosp, Kaohsiung 812, Taiwan
[4] Kaohsiung Med Univ, Coll Med, Fac Renal Care, Kaohsiung 812, Taiwan
[5] Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung 812, Taiwan
关键词
ankle-brachial index; brachial-ankle pulse wave velocity; Framingham Risk Score; hemodialysis; overall and cardiovascular mortality; ANKLE-BRACHIAL INDEX; CORONARY-HEART-DISEASE; PULSE-WAVE VELOCITY; BLOOD-PRESSURE INDEX; CHRONIC KIDNEY-DISEASE; CARDIOVASCULAR-DISEASE; REVERSE EPIDEMIOLOGY; ARTERIAL STIFFNESS; AORTIC STIFFNESS; MORTALITY;
D O I
10.1111/nep.12094
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Aim The Framingham Risk Score (FRS), calculated by considering conventional risk factors of cardiovascular diseases, was developed to predict coronary heart disease in various populations. However, reverse epidemiology has been raised concerning these risk factors in predicting high cardiovascular mortality in hemodialysis patients. Our objectives are to determine whether FRS is associated with overall and cardiovascular mortality and the role of new risk markers when they were added to a FRS model in hemodialysis patients. Methods This study enrolled 201 hemodialysis patients aged 20-80 years old. The FRS is used to identify individuals categorized as low (<6% 10-year risk), intermediate (6-20% risk) or high risk (>20% risk). Medical records were reviewed to collect clinical information. Data of ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were obtained by an ABI-form device. Results The mean follow-up period was 4.4 +/- 1.5 years. Intermediate risk predicted overall hazard ratio (HR) (2.157, P=0.039) and cardiovascular mortality (HR= 5.023; P=0.004) versus low risk, but high' risk did not. High risk (vs low risk) predicted cardiovascular events (HR=2.458, P=0.05). Besides, the addition of ABI<0.9 (P=0.021) and baPWV (P=0.014) to a FRS model significantly improved the predictive value for overall mortality. Conclusion In hemodialysis patients, intermediate risk but not high risk categorization by FRS predicted overall and cardiovascular mortality, and high risk predicted cardiovascular events. ABI<0.9 and baPWV provided additional predictive values for overall mortality. Future study is needed to develop hemodialysis-specific equations and assess whether risk refinement using ABI<0.9 and baPWV leads to a meaningful change in clinical outcomes.
引用
收藏
页码:510 / 515
页数:6
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