The Association Between Progression of Carotid Artery Intima-Media Thickness and Cardiovascular Events in Peritoneal Dialysis Patients

Abstract

OBJECTIVE: Measurement of carotid artery intima-media thickness (CA-IMT) is directly associated with cardiovascular (CV) outcomes. We retrospectively investigated the impact of CA-IMT progression on new CV events in patients on peritoneal dialysis (PD).

MATERIAL and METHODS: All PD patients who have been followed in our unit (n=163) were screened. The patients who had no CA-IMT were excluded. Ninety-six patients who had baseline CAIMT measurement were included. Fifty-two patients had second CA-IMT measurement. Fatal and nonfatal CV events were screened from patients’ charts.

RESULTS: At baseline, mean CA-IMT was 0.62±0.16 mm (median 0.60 mm). In patients treated with PD more than 2 years, CV event rate was higher in patients with high CA-IMT (>0.60 mm) compared to the patients with low CA-IMT at baseline (22.2% versus 4.2%, p=0.041). In patients who had second CA-IMT measurement, mean CA-IMT increased from 0.62±0.17 mm to 0.66±0.17 mm (p=0.002). In ROC analysis, best cut-off value of CA-IMT progression was 0.0062 mm/month for prediction of CV events (AUC 0.752±0.066, p=0.046). When patients were grouped according to this cut-off value, CV event rate was higher in patients showed CA-IMT progression above 0.0062 mm/month (33.3% versus 2.7%, p=0.001). In Cox-regression analysis, progression of CA-IMT more than 0.0062 mm/month was only predictor for new CV events (ExpB=14.57, p=0.015).

CONCLUSION: Consecutive assessment of atherosclerosis progression by CA-IMT measurement has importance for prediction of new CV events in PD patients.