Risk of major cardiovascular events among incident dialysis patients: A Korean national population-based study

Kim, Hyun‐Wook; Kim, Kyoung Hoon; Ahn, Song Vogue; Kang, Shin Wook; Yoo, Tae‐Hyun; Ahn, Hyeong Sik; Hann, Hoo Jae; Lee, Shina; Ryu, Jung Hwa; Yu, Mina; Kim, Seung Jung; Kang, Duk Hee; Choi, Kyu Bok; Ryu, Dong Ryeol

doi:10.1016/j.ijcard.2015.06.120

Cited by 39 publications

(60 citation statements)

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“…The primary end-point of this study was the occurrence of MACCE during follow-up. MACCE was defined as a composite outcome of major adverse cardiac event (MACE) and nonfatal ischemic and hemorrhagic stroke [35]. MACE included all-cause mortality, nonfatal acute myocardial infarction, and target vessel revascularization, encompassing both percutaneous coronary intervention and coronary artery bypass graft.…”

Section: Methodsmentioning

confidence: 99%

Dementia is a risk factor for major adverse cardiac and cerebrovascular events in elderly Korean patients initiating hemodialysis: a Korean national population-based study

et al. 2017

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BackgroundDementia is common in end-stage renal disease (ESRD) patients on hemodialysis (HD) and is associated with worse outcomes. This study aimed to investigate the risk of major adverse cardiac and cerebrovascular event (MACCE) in elderly patients with dementia initiating HD.MethodsUsing the database from the Health Insurance Review & Assessment Service, we analyzed 10,171 patients aged 65 years or older who had initiated dialysis from 2005 to 2008. MACCE was defined as a composite outcome of all-cause mortality, nonfatal acute myocardial infarction, target vessel revascularization, and nonfatal ischemic and hemorrhagic stroke. The Kaplan-Meier method and Cox proportional hazards model were used, and further comparisons using propensity-score matching at 1:2 ratio were also performed.ResultsA total of 303 elderly patients (3.0%) had dementia at initiating HD. During follow-up, dementia was a significant predictor of MACCE after adjustment for confounding variables. In addition, further analyzed in the propensity-score matched groups, dementia was an independent predictor of both nonfatal ischemic stroke and all-cause mortality.ConclusionsDementia is an independent risk factor for mortality and ischemic stroke in elderly ESRD patients initiating HD. Patients with dementia who start dialysis should be closely monitored to reduce the risk of mortality and ischemic stroke.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-017-0547-0) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Dementia is a risk factor for major adverse cardiac and cerebrovascular events in elderly Korean patients initiating hemodialysis: a Korean national population-based study

et al. 2017

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“…The detail of HIRA database organization was described elsewhere [9]. The Institutional Review Board at the HIRA approved our use of the database for this study (IRB No.…”

Section: Methodsmentioning

confidence: 99%

“…We previously reported that, although it is being improved in recent years [7], PD is generally inferior to HD as an initial dialysis modality in Korea in terms of overall survival, and this is largely accounted for by the higher incidence of all-cause mortality, non-fatal acute myocardial infarction (MI), and vascular complications requiring target vessel revascularization [8,9] in incident PD patients. This finding was in contrast to recent studies of large-scale registry data, but the reasons for this inferiority of PD could not be adequately explained [10-12].…”

Section: Introductionmentioning

confidence: 99%

The pattern of choosing dialysis modality and related mortality outcomes in Korea: a national population-based study

Kim

Park

Han

et al. 2017

Korean J Intern Med

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Background/AimsSince comorbidities are major determinants of modality choice, and also interact with dialysis modality on mortality outcomes, we examined the pattern of modality choice according to comorbidities and then evaluated how such choices affected mortality in incident dialysis patients.MethodsWe analyzed 32,280 incident dialysis patients in Korea. Patterns in initial dialysis choice were assessed by multivariate logistic regression analyses. Multivariate Poisson regression analyses were performed to evaluate the effects of interactions between comorbidities and dialysis modality on mortality and to quantify these interactions using the synergy factor.ResultsPrior histories of myocardial infarction (p = 0.031), diabetes (p = 0.001), and congestive heart failure (p = 0.003) were independent factors favoring the initiation with peritoneal dialysis (PD), but were associated with increased mortality with PD. In contrast, a history of cerebrovascular disease and 1-year increase in age favored initiation with hemodialysis (HD) and were related to a survival benefit with HD (p < 0.001, both). While favoring initiation with HD, having Medical Aid (p = 0.001) and male gender (p = 0.047) were related to increased mortality with HD. Furthermore, although the severity of comorbidities did not inf luence dialysis modality choice, mortality in incident PD patients was significantly higher compared to that in HD patients as the severity of comorbidities increased (p for trend < 0.001).ConclusionsSome comorbidities exerted independent effects on initial choice of dialysis modality, but this choice did not always lead to the best results. Further analyses of the pattern of choosing dialysis modality according to baseline comorbid conditions and related consequent mortality outcomes are needed.

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“…It is unclear whether the choice of dialysis modality affects the risk of stroke . Each renal replacement modality causes physiological changes that may affect the risk of stroke in a different way .…”

Section: Introductionmentioning

confidence: 99%

The comparison of risk of stroke in patients with peritoneal dialysis and hemodialysis: A systematic review and meta‐analysis

Boonpheng

Cheungpasitporn

2018

J Evidence Based Medicine

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Risk of major cardiovascular events among incident dialysis patients: A Korean national population-based study

Cited by 39 publications

References 40 publications

Dementia is a risk factor for major adverse cardiac and cerebrovascular events in elderly Korean patients initiating hemodialysis: a Korean national population-based study

Dementia is a risk factor for major adverse cardiac and cerebrovascular events in elderly Korean patients initiating hemodialysis: a Korean national population-based study

The pattern of choosing dialysis modality and related mortality outcomes in Korea: a national population-based study

The comparison of risk of stroke in patients with peritoneal dialysis and hemodialysis: A systematic review and meta‐analysis

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