Association between abnormal myocardial fatty acid metabolism and cardiac-derived death among patients undergoing hemodialysis: results from a cohort study in Japan.
Abstract | BACKGROUND: STUDY DESIGN: Prospective observational study. SETTING & PARTICIPANTS: Asymptomatic hemodialysis patients with one or more cardiovascular risk factors, but without known coronary artery disease, were followed up for 3 years at 48 Japanese hospitals (406 men, 271 women; mean age, 64 years). PREDICTOR: Baseline BMIPP summed scores semiquantified using a 17-segment 5-point system (normal, 0; absent, 4). OUTCOMES: MEASUREMENTS: HRs were estimated using a Cox model for associations between BMIPP summed scores and cardiac-derived death, adjusting for potential confounders of age, sex, body mass index, dialysis duration, and cardiovascular risk factors. RESULTS: Rates of all-cause mortality and cardiac-derived death were 18.5% and 6.8%, respectively. Cardiac-derived death (acute myocardial infarction [n = 10], congestive heart failure [n = 13], arrhythmia [n = 2], valvular heart disease [n = 1], and sudden death [n = 20]) accounted for 36.8% of all-cause deaths. Cardiac-derived death (n = 46) was associated with age, history of heart failure, and BMIPP summed scores of 4 or higher (HR, 2.9; P < 0.001). Three-year cardiac-derived death-free survival rates were 95.7%, 90.6%, and 78.8% when BMIPP summed scores were 3 or lower, 4-8, and 9 or higher, respectively. BMIPP summed score also was a predictor of all-cause death (HR, 1.6; P = 0.009). LIMITATIONS:
Sudden death of unknown cause was considered to have been cardiac derived, although a coronary origin was not confirmed. CONCLUSIONS: Abnormal myocardial fatty acid metabolism is associated with cardiac-derived death in hemodialysis patients. BMIPP single- proton emission computed tomography appears clinically useful for predicting cardiac-derived death in this population.
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Authors | Masao Moroi, Nagara Tamaki, Masato Nishimura, Kazuo Haze, Tsunehiko Nishimura, Eiji Kusano, Takashi Akiba, Tokuichiro Sugimoto, Hiroki Hase, Kazuhiro Hara, Tomoaki Nakata, Shinichiro Kumita, Yoji Nagai, Akiyoshi Hashimoto, Mitsuru Momose, Keiko Miyakoda, Naoyuki Hasebe, Kenjiro Kikuchi |
Journal | American journal of kidney diseases : the official journal of the National Kidney Foundation
(Am J Kidney Dis)
Vol. 61
Issue 3
Pg. 466-75
(Mar 2013)
ISSN: 1523-6838 [Electronic] United States |
PMID | 23201161
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Cohort Studies
- Fatty Acids
(metabolism)
- Female
- Heart Diseases
(metabolism, mortality)
- Humans
- Japan
- Male
- Middle Aged
- Myocardium
(metabolism)
- Prospective Studies
- Renal Dialysis
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