Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease
Background: Intima-Media-Thickness of the carotid artery wall (cIMT) is a strong predictor of cardiovascular (CV) disease. The aim of this study was to investigate the significance of cIMT as an independent prognostic factor for CV morbidity and mortality in patients with chronic kidney disease (CKD...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Taylor & Francis Group
2019-01-01
|
Series: | Renal Failure |
Subjects: | |
Online Access: | http://dx.doi.org/10.1080/0886022X.2019.1585372 |
id |
doaj-c4ed6826efc3405f8fc30ea9e7f0abbc |
---|---|
record_format |
Article |
spelling |
doaj-c4ed6826efc3405f8fc30ea9e7f0abbc2021-06-02T08:05:28ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492019-01-0141113113810.1080/0886022X.2019.15853721585372Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney diseaseAthanasios Roumeliotis0Stefanos Roumeliotis1Stylianos Panagoutsos2Marios Theodoridis3Christos Argyriou4Anna Tavridou5George S. Georgiadis6“Democritus” University of Thrace, Medical School, University General Hospital of Alexandroupolis“Democritus” University of Thrace, Medical School, University General Hospital of Alexandroupolis“Democritus” University of Thrace, Medical School, University General Hospital of Alexandroupolis“Democritus” University of Thrace, Medical School, University General Hospital of Alexandroupolis“Democritus” University of Thrace, Medical School, University General Hospital of Alexandroupolis“Democritus” University of Thrace, Medical School“Democritus” University of Thrace, Medical School, University General Hospital of AlexandroupolisBackground: Intima-Media-Thickness of the carotid artery wall (cIMT) is a strong predictor of cardiovascular (CV) disease. The aim of this study was to investigate the significance of cIMT as an independent prognostic factor for CV morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes mellitus type 2 (DM2). Methods: The study included 142 diabetic patients in different stages of CKD. Patients were categorized into two groups according to low (≤0.86 mm) or high cIMT (>0.86 mm), respectively. CV events and death from all causes were registered during a seven-year follow-up. Results: Mean age, BMI and duration of diabetes were 68 years (range: 45–90), >30 kg/m2 and 15 years (range: 5–40), respectively. Patients with increased cIMT were older, suffered from a lower estimated glomerular filtration rate (eGFR), peripheral atherosclerosis and plaque presence in either carotid artery. Increased BMI (beta= −0.29, p = .01), lower eGFR (beta = 0.353, p = .003) and male gender (beta= −0.339, p = .005) were found to predict increased cIMT. Predictors of all-cause mortality in Cox proportional hazard models were low eGFR and high cIMT with HR = 0.96 (CI = 0.94–0.98), p < .001 and HR = 2.9 (CI = 1.03–7.99), p = .04, respectively. The risk of future CV event was determined by albuminuria and cIMT with HR = 1 (CI = 1.0–1.0), p < .001 and HR = 2.04 (CI = 1.1–3.78), p = .02, respectively. Patients with high cIMT presented significantly higher all-cause mortality and a new CV event (p = .005/p = .018, respectively). Conclusions: cIMT is a strong and independent predictor of CV morbidity and mortality, and should be considered a valuable tool for the stratification of CV risk in patients with CKD and DM2.http://dx.doi.org/10.1080/0886022X.2019.1585372carotid intima-media thicknessdiabetes mellitus type 2cardiovascular disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Athanasios Roumeliotis Stefanos Roumeliotis Stylianos Panagoutsos Marios Theodoridis Christos Argyriou Anna Tavridou George S. Georgiadis |
spellingShingle |
Athanasios Roumeliotis Stefanos Roumeliotis Stylianos Panagoutsos Marios Theodoridis Christos Argyriou Anna Tavridou George S. Georgiadis Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease Renal Failure carotid intima-media thickness diabetes mellitus type 2 cardiovascular disease |
author_facet |
Athanasios Roumeliotis Stefanos Roumeliotis Stylianos Panagoutsos Marios Theodoridis Christos Argyriou Anna Tavridou George S. Georgiadis |
author_sort |
Athanasios Roumeliotis |
title |
Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_short |
Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_full |
Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_fullStr |
Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_full_unstemmed |
Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
title_sort |
carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease |
publisher |
Taylor & Francis Group |
series |
Renal Failure |
issn |
0886-022X 1525-6049 |
publishDate |
2019-01-01 |
description |
Background: Intima-Media-Thickness of the carotid artery wall (cIMT) is a strong predictor of cardiovascular (CV) disease. The aim of this study was to investigate the significance of cIMT as an independent prognostic factor for CV morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes mellitus type 2 (DM2). Methods: The study included 142 diabetic patients in different stages of CKD. Patients were categorized into two groups according to low (≤0.86 mm) or high cIMT (>0.86 mm), respectively. CV events and death from all causes were registered during a seven-year follow-up. Results: Mean age, BMI and duration of diabetes were 68 years (range: 45–90), >30 kg/m2 and 15 years (range: 5–40), respectively. Patients with increased cIMT were older, suffered from a lower estimated glomerular filtration rate (eGFR), peripheral atherosclerosis and plaque presence in either carotid artery. Increased BMI (beta= −0.29, p = .01), lower eGFR (beta = 0.353, p = .003) and male gender (beta= −0.339, p = .005) were found to predict increased cIMT. Predictors of all-cause mortality in Cox proportional hazard models were low eGFR and high cIMT with HR = 0.96 (CI = 0.94–0.98), p < .001 and HR = 2.9 (CI = 1.03–7.99), p = .04, respectively. The risk of future CV event was determined by albuminuria and cIMT with HR = 1 (CI = 1.0–1.0), p < .001 and HR = 2.04 (CI = 1.1–3.78), p = .02, respectively. Patients with high cIMT presented significantly higher all-cause mortality and a new CV event (p = .005/p = .018, respectively). Conclusions: cIMT is a strong and independent predictor of CV morbidity and mortality, and should be considered a valuable tool for the stratification of CV risk in patients with CKD and DM2. |
topic |
carotid intima-media thickness diabetes mellitus type 2 cardiovascular disease |
url |
http://dx.doi.org/10.1080/0886022X.2019.1585372 |
work_keys_str_mv |
AT athanasiosroumeliotis carotidintimamediathicknessisanindependentpredictorofallcausemortalityandcardiovascularmorbidityinpatientswithdiabetesmellitustype2andchronickidneydisease AT stefanosroumeliotis carotidintimamediathicknessisanindependentpredictorofallcausemortalityandcardiovascularmorbidityinpatientswithdiabetesmellitustype2andchronickidneydisease AT stylianospanagoutsos carotidintimamediathicknessisanindependentpredictorofallcausemortalityandcardiovascularmorbidityinpatientswithdiabetesmellitustype2andchronickidneydisease AT mariostheodoridis carotidintimamediathicknessisanindependentpredictorofallcausemortalityandcardiovascularmorbidityinpatientswithdiabetesmellitustype2andchronickidneydisease AT christosargyriou carotidintimamediathicknessisanindependentpredictorofallcausemortalityandcardiovascularmorbidityinpatientswithdiabetesmellitustype2andchronickidneydisease AT annatavridou carotidintimamediathicknessisanindependentpredictorofallcausemortalityandcardiovascularmorbidityinpatientswithdiabetesmellitustype2andchronickidneydisease AT georgesgeorgiadis carotidintimamediathicknessisanindependentpredictorofallcausemortalityandcardiovascularmorbidityinpatientswithdiabetesmellitustype2andchronickidneydisease |
_version_ |
1721406744322637824 |