title: Impact of non-invasive cardiovascular screening programs as a predictor of cardiovascular events among asymptomatic chronic kidney disease patients.
abstract: BACKGROUND
  The clinical usefulness of physiological and radiological examinations for cardiovascular disease (CVD) risk stratification has not been fully demonstrated in chronic kidney disease (CKD) patients. In the present study, predictive values of CVD were investigated among asymptomatic CKD patients by comprehensive and non-invasive CVD screening programs.
  
  
  METHODS
  We prospectively evaluated 139 asymptomatic CKD patients. All patients were examined by comprehensive and non-invasive CVD risk screening programs that included carotid ultrasonography, coronary artery calcification score (CACS), pulse wave velocity, and flow-mediated vasodilation, and their associations with major adverse cardiovascular events (MACEs) were analyzed.
  
  
  RESULTS
  During the median follow-up of 32.3 months, 13 MACEs were observed. Among all CVD screening examinations, severity of the carotid plaque score (PS) and CACS was significantly higher in the MACE group than in the MACE-free group (11.3 ± 5.8 versus 6.1 ± 5.3, P = 0.001 and 657 versus 74, P = 0.020, respectively). Kaplan-Meier curves for the incidences of MACEs classified according to the combination of carotid PS and CACS showed that severe carotid PS and severe CACS groups had the highest event rate in comparison with the groups without any of these (29.9, 11.9, and 3.6 %, respectively, P < 0.001).
  
  
  CONCLUSIONS
  In this long-term follow-up analysis, the combination of carotid atherosclerosis and CACS was a useful and non-invasive screening tool for predicting cardiovascular events among asymptomatic CKD patients.
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sawai
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.|Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan. sususu0531@yahoo.co.jp.|Department of Cardiology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. sususu0531@yahoo.co.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Motomitsu
authors.initials: M
authors.lastname: Goto
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Cardiology, Fujita Health University Second Hospital, Nagoya, Japan.
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.affiliation: Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oiso
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D003935:Diagnostic Techniques, Cardiovascular; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D061205:Vascular Calcification / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology
keywords: Cardiovascular disease; Carotid atherosclerosis; Chronic kidney disease; Coronary artery calcium score; Non-invasive screening program