Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 609-614 |
| Number of pages | 6 |
| Journal | Kidney International |
| Volume | 61 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2002 |
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Keywords
- Arteriovenous disease
- Blood pressure
- Cardiovascular risk
- Dialysis
- Homocysteine
- Mortality study
- Thrombosis
ASJC Scopus subject areas
- Nephrology
Cite this
Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients. / Mallamaci, Francesca; Zoccali, Carmine; Tripepi, Giovanni; Fermo, Isabella; Benedetto, Francesco A.; Cataliotti, Alessandro; Bellanuova, Ignazio; Malatino, Lorenzo Salvatore; Soldarini, Armando.
In: Kidney International, Vol. 61, No. 2, 2002, p. 609-614.Research output: Contribution to journal › Article
}
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
UR - http://www.scopus.com/inward/record.url?scp=0036153990&partnerID=8YFLogxK
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 -