Background: Aortic pulse wave velocity (PWV) is a strong independent predictor of overall and cardiovascular mortality in patients with end-stage renal disease (ESRD). Nevertheless, because age, blood pressure, heart rate, and gender are strong determinants of both arterial stiffness and mortality, the individual relevance of PWV measurements remains controversial.
Methods: A cohort of 242 patients with ESRD undergoing hemodialysis was studied for a mean (+/- SD) duration of 78 +/- 46 months. At entry, together with standard clinical and biochemical analyses, PWV was measured using Doppler ultrasonography. On the basis of a nomogram established on 469 nonuremic subjects, a theoretical value of PWV was determined in ESRD patients according to their age, blood pressure, gender, and heart period. The PWV index (measured PWV - theoretical PWV) was then calculated for each individual ESRD patient.
Results: Based on Cox analysis, the PWV index, but neither pulse pressure nor cardiac mass, was a strong and independent predictor of both cardiovascular and overall mortality, together with age and time on dialysis before inclusion. Patients with positive (versus negative) PWV index had a twofold adjusted risk of mortality during the follow-up. Per each 1 meter/second PWV index increment, we observed a 34% (crude) and a 14% (adjusted) increase in both cardiovascular and overall mortality (P < 0.02 for all).
Conclusion: In ESRD patients, the calculation of a PWV index provides information about cardiovascular and overall mortality risk with high predictive power, showing that PWV measurements provide discriminatory prognostic power over and above conventional cardiovascular risk factors.
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http://dx.doi.org/10.1046/j.1523-1755.2003.00932.x | DOI Listing |
J Endovasc Ther
January 2025
Department of Vascular Surgery, Northwest Hospital Group, Alkmaar, The Netherlands.
Objective: There is a lack of consensus regarding the optimal antithrombotic therapy (ATT) after popliteal and infrapopliteal (PIP) endovascular therapy (EVT). Currently, dual antiplatelet therapy (DAPT) for 3 months and single antiplatelet therapy (SAPT) are the most prescribed regimens in the Netherlands. Thus far, no randomized comparison has been performed on the optimal ATT approach.
View Article and Find Full Text PDFAngiology
January 2025
Department of Internal Medicine, Texas Tech University Health Science Center, El Paso, TX, USA.
Breast cancer is the most common malignancy among women. While advances in detection and treatment have improved survival, breast cancer survivors face an increased risk of cardiovascular disease. However, limited data exist on cardiac outcomes after ST-elevation myocardial infarction (STEMI) in this population.
View Article and Find Full Text PDFAngiology
January 2025
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
This meta-analysis evaluates outcomes in patients undergoing bioprosthetic aortic valve replacement (bAVR), comparing different antithrombotic strategies. We conducted a systematic search through May 2024. A standard meta-analysis compared outcomes between patients who received anticoagulation therapy (AC) and those who did not.
View Article and Find Full Text PDFCirc Cardiovasc Interv
January 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, DC (R.V., K.R.C., I.M., I.B.-D., L.F.S., R.W., T.R.).
Some patients with aortic stenosis may require multiple valve interventions in their lifetime, and choosing transcatheter aortic valve replacement (TAVR) as the initial intervention may be appealing to many. If their transcatheter heart valve degenerates later in life, most will hope to undergo redo-TAVR. However, if redo-TAVR is not feasible, some may have to undergo surgical explantation of their transcatheter heart valve (TAVR-explant).
View Article and Find Full Text PDFCirc Cardiovasc Interv
January 2025
Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands (R.H.J.A.V., J.-Q.M., N.v.R.).
Background: Despite fractional flow reserve (FFR)-guided deferral of revascularization, recurrent events in patients with diabetes or after myocardial infarction remain common. This study aimed to assess the association between FFR-negative but high-risk nonculprit lesions and clinical outcomes.
Methods: This is a patient-level pooled analysis of the prospective natural-history COMBINE (OCT-FFR) study (Optical Coherence Tomography Morphologic and Fractional Flow Reserve Assessment in Diabetes Mellitus Patients) and PECTUS-obs study (Identification of Risk Factors for Acute Coronary Events by OCT After STEMI and NSTEMI Patients With Residual Non- Flow Limiting Lesions).
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