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Abstract: SA-PO925

Gender-Specific Risk of Atheromatous and Non-Atheromatous Cardiovascular Events in CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

  • Faucon, Anne-Laure, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
  • Lambert, Oriane, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
  • Alencar de Pinho, Natalia, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
  • Ayav, Carole, Centre hospitalier regional universitaire de Nancy, Nancy, Lorraine, France
  • Combe, Christian, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, Aquitaine, France
  • Fouque, Denis, Department of Nephrology, CHU Lyon Sud, Lyon, France
  • Jacquelinet, Christian, Agence de la biomedecine, La Plaine Saint-Denis, Île-de-France, France
  • Laville, Maurice, Department of Nephrology, CHU Lyon Sud, Lyon, France
  • Liabeuf, Sophie, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, Hauts-de-France, France
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Massy, Ziad, Department of Nephrology, Hopital Ambroise Pare, Boulogne-Billancourt, Ile de France, France
  • Mansencal, Nicolas, Department of Cardiology, Hopital Ambroise Pare, Boulogne Billancourt, Île-de-France, France
  • Stengel, Benedicte, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Group or Team Name

  • CKD-REIN study group
Background

The excess risk of atheromatous cardiovascular disease (CVD) in men vs women is well-known in the general population. CKD increases the risks of both atheromatous and non-atheromatous CVD (ACVD, N-ACVD), but gender-related differences in risk by CVD type are poorly documented.

Methods

Among 3033 non-dialysis CKD patients included in the CKD-REIN Cohort (65% men; 67 years; eGFR 33 mL/min/1.73m2), we reviewed all hospitalization and death reports for CV events. Using criteria from the Cardiovascular and Stroke Endpoint Definitions for Clinical Trials, these were classified into fatal and non-fatal ACVD (coronary, cerebral, lower limb artery diseases) and N-ACVD (heart failure, atrial fibrillation). Cause-specific Cox models were used to estimate adjusted hazard ratios for CV death, ACVD and N-ACVD according to gender.

Results

At baseline, the prevalence of ACVD was higher in men (46%) than in women (28%), and slightly higher for N-ACVD (33% vs 27%). During a median follow-up of 4.6[IQR 2.8;5.0] years, 98 (5.0%) men and 43 (4.1%) women died from CVD. The crude risk for ACVD was significantly higher in men than in women, but not that for N-ACVD events and CV death (Figure). Kidney function was more strongly associated with N-ACVD than with ACVD, similarly in both genders. After adjusting for age, CV risk factors, and kidney function, the excess risk of ACVD associated with men was on the borderline of significance, HR: 1.33[1.00;177]; there was none for CV death, 0.93[0.58;1.50] and N-ACVD, 0.92[0.71;1.20].

Conclusion

In CKD patients, the burden of ACVD is higher in men than in women, and largely explained by their higher prevalence of CV risk factors. In contrast, the risk of N-ACVD appears to be similar in both genders and closely associated with kidney function, suggesting a more prominent role of CKD specific risk factors including volume disorders and uremic toxins.