Wang Zhe, Jiang Aili, Wei Fang, Chen Haiyan
Department of Blood Purification, The Second Hospital of Tianjin Medical University, Hexi District, 23 Pingjiang Road, Tianjin, 300211, China.
BMC Cardiovasc Disord. 2018 Jan 25;18(1):12. doi: 10.1186/s12872-018-0747-y.
Vascular calcification is a risk factor for the pathogenesis of cardiovascular disease and mortality in dialysis patients. Nevertheless, the association between cardiac valve calcification (CVC) and the outcome of dialysis is still illusive. The purpose of this meta-analysis is to evaluate the association between theCVC and cardiovascular or all-cause mortality in dialysis patients.
Literatures involving the baseline CVC and cardiovascular or all-cause mortality in dialysis patients were searchedfrom the PubMed, Embase, as well as two Chinese databases (i.e. Wanfang and CNKI databases). Articles published before November 2016were eligible to the study.
Ten studies involving 2686 participants were included. CVC was correlated with increased risk of cardiovascular mortality (hazard risk [HR]: 2.81; 95% confidence intervals [CI]: 1.92-4.10) and all-cause mortality (HR: 1.73; 95% CI: 1.42-2.11). Subgroup analysis showed an excess risk of all-cause mortality (HR: 1.35; 95% CI: 1.02-1.79) among patients with one CVC, and increased risk of all-cause mortality in patients with two CVCs (HR 2.15; 95% CI 1.57-2.94).
CVC is correlated with higher cardiovascular and all-cause mortality risk in dialysis patients. Regular follow-up monitoring of CVC may be helpful for risk stratification of patients underwent dialysis.
血管钙化是透析患者心血管疾病发病机制和死亡的危险因素。然而,心脏瓣膜钙化(CVC)与透析结局之间的关联仍不明确。本荟萃分析的目的是评估透析患者CVC与心血管或全因死亡率之间的关联。
从PubMed、Embase以及两个中文数据库(即万方和知网数据库)中检索涉及透析患者基线CVC和心血管或全因死亡率的文献。2016年11月之前发表的文章符合本研究要求。
纳入了10项研究,共2686名参与者。CVC与心血管死亡率增加风险相关(风险比[HR]:2.81;95%置信区间[CI]:1.92 - 4.10)和全因死亡率增加风险相关(HR:1.73;95% CI:1.42 - 2.11)。亚组分析显示,单个CVC患者全因死亡率存在额外风险(HR:1.35;95% CI:1.02 - 1.79),两个CVC患者全因死亡率风险增加(HR 2.15;95% CI 1.57 - 2.94)。
CVC与透析患者较高的心血管和全因死亡风险相关。定期对CVC进行随访监测可能有助于对接受透析的患者进行风险分层。