| Derivation and validation of a disease-specific risk score for cardiac risk stratification in chronic kidney disease. | |
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MedLine Citation:
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PMID: 16014347 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cardiac events (CE; cardiac death, non-fatal myocardial infarction and acute coronary syndrome) are the principal causes of death in patients with chronic kidney disease (CKD). We sought to devise and validate a cardiac risk score to risk-stratify patients with CKD. METHODS: Clinical history and biochemical data were obtained in 167 CKD patients. CE were recorded over a median follow-up of 22 months. The hazard ratio (HR) of each independent variable using Cox regression analysis was used to derive a cardiac risk score for the prediction of events. The cardiac risk score was then applied to a validation population of 99 CKD patients to confirm its validity in predicting CE. RESULTS: CE occurred in 20 patients in the derivation group. The independent predictors of CE were cardiac history (HR 9.83, P = 0.001), body mass index (BMI; HR 1.15, P = 0.002), dialysis duration (HR 1.24, P = 0.004) and serum phosphate (HR 4.29, P = 0.001). The resulting cardiac risk score (range 26-67) gave an area under the receiver operating characteristic curve of 0.86. CE occurred in 25 patients in the validation group; the ROC curve area was similar (0.84, P = 0.11). An optimal cardiac risk score cut-off of 50 assigned high risk to 29% of the derivation and 35% of the validation group (P = 0.26). CE occurred in 35 and 57% of the high-risk derivation and validation groups, respectively (P = 0.09), and in 2 and 8% of the low-risk groups (P = 0.15). CONCLUSION: Application of a cardiac risk score using cardiac history, dialysis duration, BMI and phosphate identifies CKD patients at risk of future CE. |
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Authors:
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Kirsten A Armstrong; Dhrubo J Rakhit; Colin Case; David W Johnson; Nicole M Isbel; Thomas H Marwick |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Validation Studies Date: 2005-07-12 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 20 ISSN: 0931-0509 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-09-16 Completed Date: 2005-12-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 2097-104 Citation Subset: IM |
Affiliation:
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MBBS, University of Queensland, Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, Queensland 4102, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cardiovascular Diseases / etiology* Diabetic Nephropathies / complications Female Humans Kidney Failure, Chronic / complications* Male Middle Aged Proportional Hazards Models Risk Risk Factors Sensitivity and Specificity |
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