Abstract: TH-PO690
Abnormal Left Ventricular Metrics and Subsequent Cardiovascular Events in Japanese and US Patients with CKD: Findings from the CRIC and CKD-JAC Studies
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention
Authors
- Imaizumi, Takahiro, University of Pennsylvania, Philadelphia, United States
- Fujii, Naohiko, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan
- Hamano, Takayuki, Osaka University Graduate School of Medicine, Suita, Osaka-Fu, Japan
- Yang, Wei, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Kansal, Mayank, University of Illinois at Chicago, Chicago, Illinois, United States
- Mehta, Rupal, Northwestern Univesrsity, Feinberg School of Medicine, Chicago, Illinois, United States
- Shafi, Tariq, University of Mississippi Medical Center, Jackson, Mississippi, United States
- Taliercio, Jonathan J., Glickman Urological and Kidney Institute, Cleveland, Ohio, United States
- Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States
- Rao, Panduranga S., University of Michigan Health System, Ann Arbor, Michigan, United States
- Hamm, L. Lee, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Deo, Rajat, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Fukagawa, Masafumi, Tokai University School of Medicine, Isehara, Kanagawa, Japan
- Feldman, Harold I., University of Pennsylvania, Philadelphia, Pennsylvania, United States
Background
Left ventricular (LV) hypertrophy (LVH) is a risk factor for cardiovascular (CVD) events in patients with chronic kidney disease (CKD). The prevalence of LVH and the associated risk of subsequent CVD events in US and Japanese patients with CKD has not been clearly elucidated.
Methods
3125 participants in the Chronic Renal Insufficiency Cohort (CRIC) Study and 1097 in the CKD Japan Cohort (CKD-JAC) Study underwent echocardiography. LV mass index (LVMI), LVH (defined as LVMI >50 g/m2.7 in males and >47 g/m2.7 in females), and LV geometry (concentric hypertrophy, eccentric hypertrophy, and concentric remodeling) were assessed. Cox proportional hazards survival analysis was implemented for the composite outcome of CVD, defined as any of the following events: hospitalization for congestive heart failure, myocardial infarction, stroke, interventions for peripheral artery disease, and any lethal cardiovascular events.
Results
The mean values of LVMI and the proportion of LVH in CRIC and CKD-JAC participants were 55.7 g/m2.7 and 46.6 g/m2.7, and 59.2% and 36.1%, respectively. CRIC participants had higher proportion of concentric LVH (51.6% and 23.1%, respectively). Incidence rates of the first CVD events in the CRIC and the CKD-JAC were 35.5 and 23.5 per 1000 person-years, respectively. LVH was significantly associated with the subsequent CVD events; HRs were 1.86 (95% confidence interval, 1.53–2.26) in the pooled cohort, 1.85 (1.50–2.29) in the CRIC, and 1.91 (1.15–3.16) in the CKD-JAC (P-interaction = 0.96). Adjusted HRs of LVMI (per 10 g/m2.7) were 1.23 (1.18–1.27) in the pooled cohort. Adjusted HRs stratified by race/ethnicity were 1.23 (1.14–1.31) in non-Hispanic Whites, 1.23 (1.16–1.29) in non-Hispanic Blacks, 1.19 (1.03–1.38) in Hispanics and 1.24 (1.07–1.43) in Japanese Asians (P-interaction = 0.94).
Conclusion
US patients with CKD had a higher prevalence of LVH and higher LVMI than Japanese patients with CKD. Despite the differences in LV metrics, the association between LVMI and subsequent CVD events was similar across ethnic groups. These findings also reinforce that LVMI may be a common therapeutic target across these diverse populations.
Funding
- NIDDK Support –