Risk of major cardiovascular events among incident dialysis patients: A Korean national population-based study

Hyunwook Kim, Kyoung Hoon Kim, Song Vogue Ahn, Shin Wook Kang, Tae Hyun Yoo, Hyeong Sik Ahn, Hoo Jae Hann, Shina Lee, Jung Hwa Ryu, Mina Yu, Seung Jung Kim, Duk Hee Kang, Kyu Bok Choi, Dong Ryeol Ryu

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

Background Dialysis patients are at high risk for cardiovascular diseases, but until now there have been no detailed analyses of the incidences among Asian patients initiating dialysis. The aims of this study were to determine the incidence rates of major adverse cardiac and cerebrovascular events (MACCE) and to compare them between incident HD patients and PD patients. Methods We included all patients who had started dialysis between January 1, 2005 and December 31, 2008 in Korea, and analyzed 30,279 eligible patients [22,892 hemodialysis (HD) patients and 7387 peritoneal dialysis (PD) patients] by intention-to-treat. Median follow-up was 21.5 months. Results The crude incidence rates were as follows: MACCE, 182 per 1000 patient-years (PY); major adverse cardiac events (MACE), 138/1000 PY; all-cause mortality, 116/1000 PY; non-fatal acute myocardial infarction (AMI), 18/1000 PY; target vessel revascularization (TVR), 17/1000 PY; and non-fatal stroke, 60/1000 PY. When comparing all baseline covariate-adjusted relative risks between HD and PD patients, HD is overall superior to PD in terms of MACCE. Further examined by each endpoint, all-cause mortality, non-fatal AMI, and TVR occurred significantly more frequently in patients on PD than in those on HD, whereas non-fatal hemorrhagic stroke occurred significantly more frequently in patients on HD than in those on PD. Conclusions The incidence of MACCE may be different from Western dialysis patients. HD is overall superior to PD in terms of MACCE as an initial dialysis modality. Underlying mechanisms differentially affecting cardiovascular outcomes by dialysis modality remain to be further elucidated.

Original languageEnglish
Pages (from-to)95-101
Number of pages7
JournalInternational Journal of Cardiology
Volume198
DOIs
Publication statusPublished - 2015 Aug 28

Keywords

  • Cardiovascular disease
  • Hemodialysis
  • Peritoneal dialysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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