title: [Factors associated with cardiovascular death and events in patients with end stage renal disease].
abstract: BACKGROUND
  It is very important to evaluate atherosclerosis at an early stage since cardiovascular disease is the main cause of death in patients with end stage renal disease. The purpose of our study was to examine which of the following parameters of atherosclerosis is the best index for the prediction of cardiovascular death or events in hemodialysis patients: intima media thickness (IMT), ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI), and whether visceral fat area (VFA) and subcutaneous fat area (SFA), also predict those events.
  
  
  METHODS
  VFA, SFA, IMT, ABI and CAVI were measured using CT or a dedicated device in 270 hemodialysis patients(age: 63.3 +/- 12.3 years, male 56.3%).
  
  
  RESULTS
  During a median follow-up period of 54 months, cardiovascular deaths or events occurred in 92 (34.1%) patients. Seventy (25.9%) patients died, 27 (38.6%) of them due to cardiovascular events. Whereas several baseline clinical covariates showed an associated risk for composite cardiovascular events in a univariate Cox proportional hazards analysis, almost all of them became insignificant when analyzed together. Only age, SFA, and a prevalence of diabetes remained significant in multivariate analysis. When both IMT and ABI were included in this model, all other covariates became insignificant, while ABI, but not IMT, was also related to the prediction of cardiovascular death on top of age and SFA.
  
  
  CONCLUSIONS
  Both ABI and IMT were useful predictors for composite cardiovascular events, with ABI being also associated with a risk for cardiovascular deaths. In addition, SFA was a useful predictor for both cardiovascular events and cardiovascular deaths.
authors: Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors: Saori
authors: S
authors: Yamaguchi
authors: Tomohito
authors: T
authors: Gohda
authors: Hiromichi
authors: H
authors: Gotoh
authors: Keisuke
authors: K
authors: Omote
authors: Masako
authors: M
authors: Furukawa
authors: Yuji
authors: Y
authors: Ishikawa
authors: Yasuhiko
authors: Y
authors: Tomino
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors