Development and validation of cardiovascular risk scores for haemodialysis patients

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autor(en): Anker SD, Gillespie IA, Eckardt KU, Kronenberg F, Richards S, Drueke TB, Stenvinkel P, Pisoni RL, Robinson BM, Marcelli D, Froissart M, Floege J
Zeitschrift: International Journal of Cardiology
Jahr der Veröffentlichung: 2016
Band: 216
Seitenbereich: 68-77
ISSN: 0167-5273


Abstract

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.


FAU-Autoren / FAU-Herausgeber

Eckardt, Kai-Uwe Prof. Dr. med.
Medizinische Klinik 4 - Nephrologie und Hypertensiologie


Autor(en) der externen Einrichtung(en)
Amgen Europe GmbH
Amgen Ltd
Arbor Research Collaborative for Health
Fresenius Medical Care Deutschland GmbH
Karolinska University Hospital / Karolinska Universitetssjukhuset
Medizinische Universität Innsbruck
Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen
Universitätsklinikum Göttingen
University of Paris 11 - Paris-Sud / Université Paris XI Paris-Sud


Zitierweisen

APA:
Anker, S.D., Gillespie, I.A., Eckardt, K.-U., Kronenberg, F., Richards, S., Drueke, T.B.,... Floege, J. (2016). Development and validation of cardiovascular risk scores for haemodialysis patients. International Journal of Cardiology, 216, 68-77. https://dx.doi.org/10.1016/j.ijcard.2016.04.151

MLA:
Anker, Stefan D., et al. "Development and validation of cardiovascular risk scores for haemodialysis patients." International Journal of Cardiology 216 (2016): 68-77.

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Zuletzt aktualisiert 2018-07-10 um 03:09