Abstract: FR-OR107
Prognostic Significance of Carotid Plaque Presence in Peritoneal Dialysis Patients and Its Association with the Apolipoprotein B/Apolipoprotein A1 Ratio
Session Information
- Peritoneal Dialysis: Innovations and Clinical Practice
November 08, 2019 | Location: 147, Walter E. Washington Convention Center
Abstract Time: 05:42 PM - 05:54 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Chen, Yun, Huashan hospital, Fudan university, Shanghai, China
- Shang, Da, Huashan hospital, Fudan university, Shanghai, China
- Dai, Shuqi, Huashan hospital, Fudan university, Shanghai, China
- Hao, Chuan-Ming, Huashan Hosp., Shanghai, SHANGHAI, China
- Zhu, Tongying, Huashan hospital, Fudan university, Shanghai, China
Background
Atherosclerosis has been reported as a risk factor for cardiovascular disease in the general population. As a phenotype of atherosclerosis, carotid plaque and its influence factors are rarely discussed，especially among dialysis patients. The study aimed to investigate the prognosis-predictive significance of carotid plaques in patients on peritoneal dialysis (PD), and explore risks factors for carotid plaque presence.
Methods
It was designed as an observational, prospective study. Patients that had undergone stable peritoneal dialysis for at least 3 months were recruited and divided into two subgroups: group with carotid plaques and group without carotid plaques. Cox regression model was used to identify independent predictors of all-cause mortality, cardiovascular events and cardiovascular mortality. Risk factors correlated to the plaque-occurrence were explored by logistic regression and verified by receiver operating characteristic curve (ROC) analysis.
Results
A total of 233 PD patients (141 men) with a mean age of 56.4±16.1 years were recruited. The cohort was followed for up to 86 months (median: 36.3 months; interquartile range: 21.3 months). In the multivariable Cox regression analysis, the carotid plaque presence turned out to be an independent risk factor both of cardiovascular events (HR:2.420; 95%CI:1.157-5.064; p=0.019) and cardiovascular mortality (HR:3.346; 95%CI:1.079-10.375; p=0.036). Multivariable logistic regression showed that the apolipoprotein B/apolipoprotein A1 ratio was significantly associated with the presence of carotid plaques. ROC analysis indicated that the AUC of the apoB/apoA1 ratio was 0.640, and it was higher than that of the traditional lipid metabolism index, the non-HDL-C/HDL-C ratio (p=0.012) .
Conclusion
Carotid plaque presence can predict cardiovascular events and cardiovascular mortality in PD patients. The ApoB/ApoA1 ratio is significantly correlated to the plaque presence and it can be a more sensitive monitoring marker for predicting the presence of carotid plaques in this population than traditional lipid metabolism parameters .
Funding
- Other NIH Support