Alpha 2.0

» Articles » PMID: 39120152

Association Between Estimated Pulse Wave Velocity and In-hospital and One-year Mortality of Patients with Chronic Kidney Disease and Atherosclerotic Heart Disease: a Retrospective Cohort Analysis of the MIMIC-IV Database

Overview

Overview

Journal Ren Fail

Publisher Informa Healthcare

Date 2024 Aug 9

PMID 39120152

Authors

Authors

Xinhai Cui

Huishan Shi

Yuanlong Hu

Zhiyuan Zhang

Mengkai Lu

Jibiao Wu

Chao Li

Affiliations

Affiliations

Soon will be listed here.

Abstract

Background: Carotid-femoral pulse wave velocity has been identified as an autonomous predictor of cardiovascular mortality and kidney injury. This important clinical parameter can be non-invasively estimated using the calculated pulse wave velocity (ePWV). The objective of this study was to examine the correlation between ePWV and in-hospital as well as one-year mortality among critically ill patients with chronic kidney disease (CKD) and atherosclerotic heart disease (ASHD).

Methods: This study included a cohort of 1173 patients diagnosed with both CKD and ASHD, sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The four groups divided into quartiles according to ePWV were compared using a Kaplan-Meier survival curve to assess variations in survival rates. Cox proportional hazards models were employed to analyze the correlation between ePWV and in-hospital as well as one-year mortality among critically ill patients with both CKD and ASHD. To further investigate the dose-response relationship, a restricted cubic splines (RCS) model was utilized. Additionally, stratification analyses were performed to examine the impact of ePWV on hospital and one-year mortality across different subgroups.

Results: The survival analysis results revealed a negative correlation between higher ePWV and survival rate. After adjusting for confounding factors, higher ePWV level (ePWV > 11.90 m/s) exhibited a statistically significant association with an increased risk of both in-hospital and one-year mortality among patients diagnosed with both CKD and ASHD (HR = 4.72, 95% CI = 3.01-7.39, < 0.001; HR = 2.04, 95% CI = 1.31-3.19, = 0.002). The analysis incorporating an RCS model confirmed a linear escalation in the risk of both in-hospital and one-year mortality with rising ePWV values ( for nonlinearity = 0.619; for nonlinearity = 0.267).

Conclusions: The ePWV may be a potential marker for the in-hospital and one-year mortality assessment of CKD with ASHD, and elevated ePWV was strongly correlated with an elevated mortality risk in patients diagnosed with both CKD and ASHD.

Citing Articles

Interaction Effect of Estimated Pulse Wave Velocity and Serum Klotho Level on Chronic Kidney Disease.

Zou P, Li J, Chen L, Liu M, Nie H, Yan J Aging Med (Milton). 2025; 8(1):e70005.

PMID: 39981292 PMC: 11841740. DOI: 10.1002/agm2.70005.

References

1.

Matsushita K, van der Velde M, Astor B, Woodward M, Levey A, de Jong P . Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010; 375(9731):2073-81. PMC: 3993088. DOI: 10.1016/S0140-6736(10)60674-5. View

2.

Huang H, Bu X, Pan H, Yang S, Cheng W, Shubhra Q . Estimated pulse wave velocity is associated with all-cause and cardio-cerebrovascular disease mortality in stroke population: Results from NHANES (2003-2014). Front Cardiovasc Med. 2023; 10:1140160. PMC: 10154635. DOI: 10.3389/fcvm.2023.1140160. View

3.

Sarnak M, Amann K, Bangalore S, Cavalcante J, Charytan D, Craig J . Chronic Kidney Disease and Coronary Artery Disease: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019; 74(14):1823-1838. DOI: 10.1016/j.jacc.2019.08.1017. View

4.

Javaid A, Mitchell J, Villines T . Predictors of Coronary Artery Calcium and Long-Term Risks of Death, Myocardial Infarction, and Stroke in Young Adults. J Am Heart Assoc. 2021; 10(22):e022513. PMC: 8751911. DOI: 10.1161/JAHA.121.022513. View

5.

Palombo C, Kozakova M . Arterial stiffness, atherosclerosis and cardiovascular risk: Pathophysiologic mechanisms and emerging clinical indications. Vascul Pharmacol. 2015; 77:1-7. DOI: 10.1016/j.vph.2015.11.083. View

6.

Gansevoort R, Correa-Rotter R, Hemmelgarn B, Jafar T, Lambers Heerspink H, Mann J . Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet. 2013; 382(9889):339-52. DOI: 10.1016/S0140-6736(13)60595-4. View

7.

Zhang R, Shi S, Chen W, Wang Y, Lin X, Zhao Y . Independent effects of the triglyceride-glucose index on all-cause mortality in critically ill patients with coronary heart disease: analysis of the MIMIC-III database. Cardiovasc Diabetol. 2023; 22(1):10. PMC: 9838037. DOI: 10.1186/s12933-023-01737-3. View

8.

Vlachopoulos C, Xaplanteris P, Aboyans V, Brodmann M, Cifkova R, Cosentino F . The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology.... Atherosclerosis. 2015; 241(2):507-32. DOI: 10.1016/j.atherosclerosis.2015.05.007. View

9.

Hsu P, Lee W, Tsai W, Chen Y, Chu C, Yen H . Comparison between estimated and brachial-ankle pulse wave velocity for cardiovascular and overall mortality prediction. J Clin Hypertens (Greenwich). 2020; 23(1):106-113. PMC: 8030022. DOI: 10.1111/jch.14124. View

10.

Schefold J, Filippatos G, Hasenfuss G, Anker S, von Haehling S . Heart failure and kidney dysfunction: epidemiology, mechanisms and management. Nat Rev Nephrol. 2016; 12(10):610-23. DOI: 10.1038/nrneph.2016.113. View

11.

Chen C, Bao W, Chen C, Chen L, Wang L, Gong H . Association between estimated pulse wave velocity and all-cause mortality in patients with coronary artery disease: a cohort study from NHANES 2005-2008. BMC Cardiovasc Disord. 2023; 23(1):412. PMC: 10441734. DOI: 10.1186/s12872-023-03435-0. View

12.

Jin W, Chowienczyk P, Alastruey J . Estimating pulse wave velocity from the radial pressure wave using machine learning algorithms. PLoS One. 2021; 16(6):e0245026. PMC: 8238176. DOI: 10.1371/journal.pone.0245026. View

13.

Ripolles-Melchor J, Fernandez Dorado F, Rubio Aguilera A, Criado Camargo A, Chico Garcia M, Abad-Motos A . Association between preoperative baseline pulse pressure and estimated pulse wave velocity and acute renal failure and mortality following colorectal surgery. A single-centre observational study. Rev Esp Anestesiol Reanim (Engl Ed). 2021; 68(10):564-575. DOI: 10.1016/j.redare.2021.02.004. View

14.

Bos W, Verrij E, Vincent H, Westerhof B, Parati G, van Montfrans G . How to assess mean blood pressure properly at the brachial artery level. J Hypertens. 2007; 25(4):751-5. DOI: 10.1097/HJH.0b013e32803fb621. View

15.

Drolz A, Fuhrmann V . [Clinical presentation of bleeding in critically ill patients in the intensive care unit : Organ systems and clinical implications]. Med Klin Intensivmed Notfmed. 2021; 116(6):482-490. DOI: 10.1007/s00063-021-00845-w. View

16.

Bosch N, Cimini J, Walkey A . Atrial Fibrillation in the ICU. Chest. 2018; 154(6):1424-1434. PMC: 6335260. DOI: 10.1016/j.chest.2018.03.040. View

17.

Markwart R, Saito H, Harder T, Tomczyk S, Cassini A, Fleischmann-Struzek C . Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis. Intensive Care Med. 2020; 46(8):1536-1551. PMC: 7381455. DOI: 10.1007/s00134-020-06106-2. View

18.

Gyongyosi H, Szollosi G, Csenteri O, Jancso Z, Moczar C, Torzsa P . Differences between SCORE, Framingham Risk Score, and Estimated Pulse Wave Velocity-Based Vascular Age Calculation Methods Based on Data from the Three Generations Health Program in Hungary. J Clin Med. 2024; 13(1). PMC: 10779891. DOI: 10.3390/jcm13010205. View

19.

Townsend R, Anderson A, Chirinos J, Feldman H, Grunwald J, Nessel L . Association of Pulse Wave Velocity With Chronic Kidney Disease Progression and Mortality: Findings From the CRIC Study (Chronic Renal Insufficiency Cohort). Hypertension. 2018; 71(6):1101-1107. PMC: 6342478. DOI: 10.1161/HYPERTENSIONAHA.117.10648. View

20.

Pauklin P, Eha J, Tootsi K, Kolk R, Paju R, Kals M . Atrial fibrillation is associated with increased central blood pressure and arterial stiffness. J Clin Hypertens (Greenwich). 2021; 23(8):1581-1587. PMC: 8678833. DOI: 10.1111/jch.14323. View