Development and validation of cardiovascular risk scores for haemodialysis patients.

Détails

ID Serval
serval:BIB_CBE94E2774EE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Development and validation of cardiovascular risk scores for haemodialysis patients.
Périodique
International journal of cardiology
Auteur(s)
Anker S.D., Gillespie I.A., Eckardt K.U., Kronenberg F., Richards S., Drueke T.B., Stenvinkel P., Pisoni R.L., Robinson B.M., Marcelli D., Froissart M., Floege J.
Collaborateur(s)
On behalf the ARO Steering Committee (collaborators)
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Statut éditorial
Publié
Date de publication
01/08/2016
Peer-reviewed
Oui
Volume
216
Pages
68-77
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
A simple clinical tool to predict cardiovascular disease risk does not exist for haemodialysis patients. The long-term coronary risk Framingham Heart Study Risk score (FRS), although used in this population, may be inadequate. Therefore, we developed separate risk-scores for cardiovascular mortality (CVM) and cardiovascular morbidity & mortality (CVMM) in a Fresenius Medical Care-based haemodialysis patient cohort (AROii).
Applying a modified FRS approach, we derived and internally validated two-year risk-scores in incident European adult patients randomly assigned to a development (N=4831) or a validation (N=4796) dataset. External validation was conducted in the third Dialysis Outcomes and Practice Patterns Study (DOPPS III) cohort. Additional discrimination comparing to the FRS was performed.
The overall two-year CVM and CVMM event rates were 5.0 and 22.6 per 100 person-years respectively. Common risk predictors included increasing age, cardiovascular disease history, primary diabetic nephropathy, low blood pressure, and inflammation. The CVM score was more predictive in AROii (c-statistic 0.72) and in DOPPS III (c-statistic 0.73-0.74) than the CVMM score (c-statistic 0.66-0.67 & 0.63 respectively). The FRS was not predictive of either CVM (c-statistic 0.54) or CVMM (c-statistic 0.56) in AROii.
We describe novel, easy-to-apply and interpret CV risk-scores for haemodialysis patients. Our improved cardiovascular prediction performance over traditional (FRS) scores reflected its tailored development and validation in haemodialysis populations, and the integration of non-classical cardiovascular risk factors. The lower expected versus observed CVM and CVMM risk suggests the existence of novel cardiovascular risk factors in this patient population not measured in this study.

Mots-clé
Adult, Aged, Aged, 80 and over, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Cohort Studies, Europe/epidemiology, European Continental Ancestry Group/statistics & numerical data, Female, Humans, Male, Middle Aged, Random Allocation, Renal Dialysis/adverse effects, Renal Dialysis/mortality, Risk Assessment/methods, Risk Factors, Cardiovascular disease, Framingham, Nephrology, Risk prediction, Validation
Pubmed
Web of science
Création de la notice
09/03/2018 19:08
Dernière modification de la notice
21/08/2019 6:35
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