TY - JOUR
T1 - Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients
AU - Mallamaci, Francesca
AU - Zoccali, Carmine
AU - Tripepi, Giovanni
AU - Fermo, Isabella
AU - Benedetto, Francesco A.
AU - Cataliotti, Alessandro
AU - Bellanuova, Ignazio
AU - Malatino, Lorenzo Salvatore
AU - Soldarini, Armando
PY - 2002
Y1 - 2002
N2 - Background. We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 ± 12 months. Methods. Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95% confidence interval (CI). Results. During the follow-up period 51 patients died, 31 of them (61%) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P = 0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95% CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P = 0.005). Conclusions. There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.
AB - Background. We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 ± 12 months. Methods. Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95% confidence interval (CI). Results. During the follow-up period 51 patients died, 31 of them (61%) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P = 0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95% CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P = 0.005). Conclusions. There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.
KW - Arteriovenous disease
KW - Blood pressure
KW - Cardiovascular risk
KW - Dialysis
KW - Homocysteine
KW - Mortality study
KW - Thrombosis
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UR - http://www.scopus.com/inward/citedby.url?scp=0036153990&partnerID=8YFLogxK
U2 - 10.1046/j.1523-1755.2002.00144.x
DO - 10.1046/j.1523-1755.2002.00144.x
M3 - Article
C2 - 11849403
AN - SCOPUS:0036153990
VL - 61
SP - 609
EP - 614
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 2
ER -