Document Detail


The association of sudden cardiac death with inflammation and other traditional risk factors.
MedLine Citation:
PMID:  18769368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite the frequency of cardiovascular death in dialysis patients, few studies have prospectively measured sudden cardiac death in these individuals. Here, we sought to determine the frequency of sudden cardiac death and its association with inflammation and other risk factors among the CHOICE (Choices for Healthy Outcomes In Caring for ESRD) cohort of 1,041 incident dialysis patients. Sudden cardiac death was defined as that occurring outside of the hospital with an underlying cardiac cause from death certificate data. Over a median 2.5 years of follow-up, 22% of all mortality in this cohort was due to sudden cardiac death. Using Cox proportional hazards, we found that the highest tertiles of high-sensitivity C-reactive protein and of IL-6 were each associated with twice the risk of sudden cardiac death compared to their lowest tertiles when adjusted for demographics, comorbidities and laboratory factors. A decrement in serum albumin was associated with a 1.35 times increased risk for sudden cardiac death in the highest compared to the lowest tertile. These findings were robust and consistent when accounting for competing risks of death from other causes. Hence, we found that sudden cardiac death is common among patients with end stage renal disease and that inflammation and malnutrition significantly increased its occurrence independent of traditional cardiovascular risk factors.
Authors:
Rulan S Parekh; Laura C Plantinga; W H Linda Kao; Lucy A Meoni; Bernard G Jaar; Nancy E Fink; Neil R Powe; Josef Coresh; Michael J Klag
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-09-03
Journal Detail:
Title:  Kidney international     Volume:  74     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-31     Completed Date:  2009-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1335-42     Citation Subset:  IM    
Affiliation:
Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA. rsparekh@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
C-Reactive Protein / analysis
Cause of Death
Cohort Studies
Death, Sudden, Cardiac / etiology*
Female
Humans
Inflammation / complications*
Interleukin-6 / blood
Kidney Failure, Chronic / complications*
Male
Middle Aged
Renal Dialysis
Risk Factors
Serum Albumin
Grant Support
ID/Acronym/Agency:
1 R01 DK070657-01/DK/NIDDK NIH HHS; 1UO1-DK-57304-01/DK/NIDDK NIH HHS; K24-DK-02643/DK/NIDDK NIH HHS; K24-DK-02856/DK/NIDDK NIH HHS; R01-DK-59616/DK/NIDDK NIH HHS; R01-HL-62985/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Interleukin-6; 0/Serum Albumin; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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