Impaired renal function impacts negatively on vascular stiffness in patients with coronary artery disease

Rossi, Sabrina; McQuarrie, Emily P.; Miller, William H.; Mackenzie, Ruth M.; Dymott, Jane A.; Moreno, María U.; Taurino, Chiara; Miller, Ashley M.; Neisius, Ulf; Berg, G; Valuckienė, Živilė; Hannay, Jonathan; Dominiczak, Anna F.; Delles, Christian

doi:10.1186/1471-2369-14-173

Cited by 14 publications

(9 citation statements)

References 39 publications

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“…Reduced GFR has been associated with central arterial stiffness in terms of a higher augmentation index (Andrade et al 2008). Coronary artery disease (CAD) patients with impaired renal function have greater cfPWV values compared to those with CAD and normal renal function (Rossi et al 2013). Our study showed that log-Cre is positively correlated with cfPWV values among our KT patients.…”

Section: Discussionsupporting

confidence: 58%

High Serum Osteoprotegerin Is Associated with Arterial Stiffness in Kidney Transplant Patients

Hsu

Shih

Chen

et al. 2015

Tohoku J. Exp. Med.

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Osteoprotegerin (OPG) is a cytokine that regulates bone resorption by inhibiting osteoclastogenesis, and OPG has been implicated in the process that causes vascular stiffness. An increase in serum OPG level has been associated with the development of arterial stiffness. Kidney transplant (KT) patients are susceptible to aortic stiffness, which is considered to be a predictor of cardiovascular events in this patient population. Carotid-femoral pulse wave velocity (cfPWV) has emerged as a gold standard for non-invasive evaluation of aortic stiffness. The aim of this study was to evaluate the relationship between serum OPG concentration and cfPWV among KT patients. Fasting blood samples were obtained from 57 KT patients and their cfPWV was measured using applanation tonometry. The serum OPG levels were measured using an enzyme-linked immunosorbent assay. Univariable linear regression analysis showed that the cfPWV in KT patients was significantly and positively correlated with age, body weight, waist circumference, body mass index, log-creatinine, systolic blood pressure, diastolic blood pressure, pulse pressure, and the log-OPG concentration. KT patients with metabolic syndrome had higher cfPWV values than those without metabolic syndrome (P = 0.036), which indicates a higher incidence of aortic stiffness in this patient population. Multivariable forward stepwise linear regression analysis of the significant variables showed that the log-OPG (P = 0.001), the log-creatinine (P = 0.004), and the SBP (P = 0.005) remained as independent and positive predictors of cfPWV values. These findings indicate that serum OPG levels are positively associated with cfPWV in KT patients.

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Section: Discussionsupporting

confidence: 58%

High Serum Osteoprotegerin Is Associated with Arterial Stiffness in Kidney Transplant Patients

Hsu

Shih

Chen

et al. 2015

Tohoku J. Exp. Med.

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“…30,31 Finally, AKI alters tissue healing and may potentially interfere with myocardial recovery after infarction. [32][33][34] Currently, patients with AKI are managed with supportive therapy because of the absence of specific strategies for established AKI. Almost all therapeutic agents that have been previously tested for this indication have failed to reach clinical practice, although some promising approaches in the prevention of AKI are being explored.…”

Section: Discussionmentioning

confidence: 99%

Association Between Acute Kidney Injury and In-Hospital Mortality in Patients Undergoing Percutaneous Coronary Interventions

Kooiman

Seth

Nallamothu

et al. 2015

Circ: Cardiovascular Interventions

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A cute kidney injury (AKI) is a common complication of percutaneous coronary intervention (PCI) and is associated with increased morbidity, mortality, duration of hospital stay, and healthcare cost. [1][2][3] Although AKI is generally a reversible condition, patients developing this complication post PCI may experience up to 20-fold increase in their in-hospital mortality risk. 4 Interpretation of results reported by previous studies on the association between AKI and mortality post PCI is hampered by the fact that both outcomes share common risk factors, such as hemodynamic instability, heart failure, diabetes mellitus, and preexisting chronic kidney disease. It therefore remains unclear whether the occurrence of AKI is independently associated with mortality and if the mortality risk associated with AKI is clinically relevant in relation to the broader population of patients undergoing PCI. Our study seeks to address this gap in knowledge by studying the association between AKI and in-hospital mortality after adjustment for confounding by common risk factors among a large population undergoing contemporary PCI. Second, we analyzed the attributable risk fraction of AKI-related in-hospital mortality. MethodsThis study was performed using data from the Blue Cross Blue Shield of Michigan cardiovascular consortium (BMC2), a regional registry of all patients undergoing PCI at nonfederal hospitals in Michigan. A detailed outline of the BMC2 registry has previously been described.5-7 Briefly, consecutive patients undergoing PCI at the 47 participating centers were included. Data on procedural and demographic patient characteristics, medication, laboratory values, renal Background-Acute kidney injury (AKI) post percutaneous coronary intervention (PCI) is associated with increased mortality but both death and AKI share common risk factors. Moreover, the effect of a high contrast dose, a known modifiable risk factor for AKI, on mortality is unknown. The aim of our study was to analyze the association between AKI and in-hospital mortality post PCI after adjustment for confounding by common risk factors. Methods and Results-This study was performed using a regional registry of all patients undergoing PCI in Michigan.Primary end points were AKI (serum creatinine increase >0.5 mg/dL) and all-cause in-hospital mortality. Propensity matching was performed, with each AKI patient matched to 4 controls. Attributable risk fraction and the exposed index number of AKI for mortality were calculated within the propensity-matched cohort. Between 2010 and 2013, 92 317 patients underwent PCI, of whom 2141 (2.3%) developed AKI. We matched 1371/2141 patients with AKI to 5484 controls. AKI was strongly associated with mortality (odds ratio=12.52, 95% confidence interval 9.29-16.86) in the propensity-matched cohort. The attributable risk fraction for mortality of AKI was 31.4% (95% confidence interval 26.8%-37.5%), and one death could be prevented for every 9 cases of AKI successfully avoided. The independent impact of a high contrast dose a...

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“…Of those, 424 use at least 1 of the arterial stiffness parameters outlined in this article, with the majority using cfPWV (314 articles) or AIx (159 articles). Many of these address large artery stiffness in disease, including but not limited to hypertension [32], renal disease [33], diabetes [34], coronary artery conditions [35,36], and heart failure [37], as well as postsurgical risk quantification such as in coronary artery intervention [38]. As review articles exist on arterial stiffness in these diseases elsewhere, and a thorough review of all would not be possible here, the remainder of this article addresses the population data gathered on SphygmoCor technology measurement of large artery stiffness, and the clinical use of these values.…”

Section: Clinical Evidence and Trialsmentioning

confidence: 99%

Large Artery Stiffness Assessment Using SphygmoCor Technology

Butlin

Qasem

2016

Pulse

202

189

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Large artery stiffness assessment has been an integral part of the SphygmoCor technology since 1998. Aortic stiffness is approximated with non-invasive measurement of carotid-femoral pulse wave velocity, with improvements made with time to make the assessment procedure quicker and more user independent. Also standard in the devices is the ability to reliably calculate the central aortic waveform shape from a peripheral pressure waveform from either the brachial or radial artery. This waveform contains much information beyond peak and trough (systolic and diastolic pressure). Relative waveform features such as the augmentation index, wave reflection magnitude, reflection time index, and subendocardial viability ratio are parameters that are influenced by the stiffness of systemic arteries. This article briefly describes these parameters related to large artery stiffness and provides reference to validation and repeatability studies relative to the clinical use of the SphygmoCor devices. It is beyond the scope to review here the 424 original research articles that have employed SphygmoCor devices in measuring arterial stiffness. Instead, the method of measurement across the devices is described, including tonometry, volumetric displacement through cuff placement around limbs, and ambulatory monitoring. Key population and subpopulation studies are cited where the average stiffness parameter progression with age and gender, as measured by SphygmoCor devices, is quantified in the healthy and general population. Finally, with reference to guidelines from working groups on arterial stiffness and hypertension, the clinical utility of large artery stiffness measurement is discussed in the context of the arterial stiffness parameters provided by the SphygmoCor systems.

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Impaired renal function impacts negatively on vascular stiffness in patients with coronary artery disease

Cited by 14 publications

References 39 publications

High Serum Osteoprotegerin Is Associated with Arterial Stiffness in Kidney Transplant Patients

High Serum Osteoprotegerin Is Associated with Arterial Stiffness in Kidney Transplant Patients

Association Between Acute Kidney Injury and In-Hospital Mortality in Patients Undergoing Percutaneous Coronary Interventions

Large Artery Stiffness Assessment Using SphygmoCor Technology

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