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Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD.
- Source :
-
Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2012 Jun; Vol. 7 (6), pp. 949-56. Date of Electronic Publication: 2012 Mar 29. - Publication Year :
- 2012
-
Abstract
- Background and Objectives: Cardiovascular disease is the most common cause of death in CKD. This study evaluated whether electrocardiogram (ECG) abnormalities are predictors of cardiovascular death in CKD.<br />Design, Setting, Participants, & Measurements: The Cardiovascular Health Study limited database (1989-2005) was used to identify a cohort with CKD at baseline (estimated GFR < 60 mL/min per 1.73 m(2)). The patients were categorized as having major, minor, or no ECG abnormalities. Rates of adjudicated cardiovascular events and mortality were compared among the groups using proportional hazards regression models.<br />Results: A total of 1192 participants had CKD at baseline; mean age ± SD was 74.7±6.2 years. Of these patients, 452 (38.8%) had major, 346 (29.7%) had minor, and 367 (31.5%) had no ECG abnormalities. Participants with estimated GFR < 60 mL/min per 1.73 m(2) were more likely to have ECG abnormalities at baseline (adjusted prevalence odds ratio, 1.23 [95% confidence interval (CI), 1.06-1.43]) than those with GFR ≥ 60 mL/min per 1.73 m(2). During mean follow-up of 10.3±3.8 years, 814 (68.3%) participants died. Compared with participants without ECG abnormalities, participants with major abnormalities had the highest risk for cardiovascular events and death; adjusted hazard ratios were 2.15 (95% CI, 1.56-2.98) and 2.27 (95% CI, 1.56-3.30), respectively. For minor ECG abnormalities, hazard ratios were 1.24 (95% CI, 0.91-1.70) and 1.48 (95% CI, 1.00-2.18), respectively.<br />Conclusions: In patients with CKD, major ECG abnormalities are frequently present and predict a significantly higher risk for death and adverse cardiovascular outcomes.
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Analysis of Variance
Cardiovascular Diseases etiology
Cause of Death
Chronic Disease
Female
Glomerular Filtration Rate
Humans
Kaplan-Meier Estimate
Kidney physiopathology
Kidney Diseases complications
Kidney Diseases diagnosis
Kidney Diseases physiopathology
Logistic Models
Male
Odds Ratio
Predictive Value of Tests
Prevalence
Prognosis
Proportional Hazards Models
Risk Assessment
Risk Factors
Time Factors
United States epidemiology
Cardiovascular Diseases diagnosis
Cardiovascular Diseases mortality
Electrocardiography
Kidney Diseases mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1555-905X
- Volume :
- 7
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Clinical journal of the American Society of Nephrology : CJASN
- Publication Type :
- Academic Journal
- Accession number :
- 22461533
- Full Text :
- https://doi.org/10.2215/CJN.07440711