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. 2022 Nov 17:9:943718.
doi: 10.3389/fcvm.2022.943718. eCollection 2022.

Joint effects of carotid plaques and renal impairment on the risk of cardiovascular disease and all-cause death in a community-based population: The Kailuan cohort study

Wen Li  1 , Wenkun Bai  1 , Congliang Miao  2 , Shuohua Chen  3 , Xinyu Zhang  1 , Yanfeng Fan  1 , Xiao Li  1 , Shouling Wu  3 , Xuemei Liu  4 , Jiang Hong  2
Affiliations

Joint effects of carotid plaques and renal impairment on the risk of cardiovascular disease and all-cause death in a community-based population: The Kailuan cohort study

Wen Li et al. Front Cardiovasc Med. .

Abstract

Objective: It is unknown whether renal impairment and atherosclerosis increase the risk of cardiovascular disease (CVD) and death. Atherosclerosis already raises the risk of CVD and all-cause death. This study investigated the joint effects of carotid plaques and renal impairment on CVD and all-cause death in community-based populations.

Methods: The study cohort consisted of 20,416 participants from the Kailuan Study who completed a carotid plaque ultrasound in 2012. A glomerular filtration rate (GFR) of < 60 ml/min or trace semiquantitative proteinuria or higher were both considered signs of renal insufficiency. We divided them into four groups according to the presence of carotid plaque and renal impairment. These groups were categorized as no carotid plaque, estimated glomerular filtration rate (eGFR) ≥ 60 ml/min, and proteinuria < trace; no carotid plaque, eGFR < 60 ml/min, and proteinuria ≥ trace; carotid plaque, eGFR ≥ 60 ml/min and proteinuria < trace; and carotid plaque, eGFR < 60 ml/min, and proteinuria ≥ trace, respectively. We investigated the combined effect of renal impairment and carotid plaque on cardiovascular events and all-cause death in the Kailuan community-based population.

Result: Participants with carotid plaque, eGFR < 60 ml/min and proteinuria had a 2.88-fold higher risk of all-cause death (95% CI, 2.18-3.80), which was significantly higher than those with lone factors (HR, 1.57; 95% CI, 1.04-2.36; and HR, 1.91; 95% CI, 1.56-2.32), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group. Participants with carotid plaque, eGFR < 60 ml/min, and proteinuria had a 1.05-fold higher risk of CVD (95% CI, 0.82-1.35), which was not higher than those with alone factors (HR, 1.35; 95% CI, 1.02-1.80; and HR, 1.12; 95% CI, 0.96-1.30), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group. Stratified analysis by age, participants with the carotid plaque, eGFR < 60 ml/min and proteinuria had a 2.98-fold higher risk of all-cause death (95% CI: 2.24-3.96), which was significantly higher than participants with lone factors (HR, 1.68; 95% CI, 1.10-2.59; and HR, 1.95; 95% CI, 1.59-2.40), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group in the age of ≥ 50 years. Participants with carotid plaque, eGFR < 60 ml/min and proteinuria had a 1.66-fold higher risk of CVD (95% CI: 1.29-2.25), which was significantly higher than participants with lone factors (HR, 1.63; 95% CI, 1.20-2.22, and HR, 1.28; 95% CI, 1.11-1.49), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group, in the age of ≥ 50 years.

Conclusion: The joint of carotid plaques and renal impairment may further increase the risk of CVD and all-cause death compared with participants with alone factors in the age of ≥ 50 years, but not in the age of < 50 years, from a community-based study.

Keywords: all-cause death; cardiovascular disease; carotid plaque; community-based populations; estimated glomerular filtration rate.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer YSh declared a shared affiliation with several of the authors, WL, WB, XZ, YF, and XLi to the handling editor at the time of review.

Figures

FIGURE 1
FIGURE 1
Flow chart of the study participants.
FIGURE 2
FIGURE 2
Association of carotid plaque and renal impairment with all-cause death and cardiovascular disease events. §Cerebral ischemia or myocardial infarction. *The model was adjusted for age, sex, smoking, alcohol, body mass index, fasting blood glucose, total cholesterol, low-density lipoprotein-cholesterol, systolic blood pressure, diastolic blood pressure, antihypertensive drug use, and lipid-lowering drug use. eGFR, estimated glomerular filtration rate; HR, hazard ratio.
FIGURE 3
FIGURE 3
Association of carotid plaque and renal impairment with all-cause death and cardiovascular disease events in subgroups stratified according to age. §Cerebral ischemia or myocardial infarction. *The model was adjusted for age, sex, smoking, alcohol, body mass index, fasting blood glucose, total cholesterol low-density lipoprotein-cholesterol, systolic blood pressure, diastolic blood pressure, antihypertensive drug use, and lipid-lowering drug use. eGFR, estimated glomerular filtration rate: HR, hazard ratio.
FIGURE 4
FIGURE 4
Association of carotid plaque and renal impairment with all-cause death and cardiovascular disease events in subgroups stratified according to age.
FIGURE 5
FIGURE 5
Kaplan-Meier survival curve for all-cause death and CVD event.
FIGURE 6
FIGURE 6
Kaplan-Meier survival curve for all-cause death and CVD event in participants aged ≥50 years.
See this image and copyright information in PMC

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References

    1. Wen CP, Cheng TYD, Tsai MK, Chang YC, Chan HT, Tsai SP, et al. All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan. Lancet. (2008) 371:2173–82. 10.1016/s0140-6736(08)60952-6 - DOI - PubMed
    1. Barr ELM, Reutens A, Magliano DJ, Wolfe R, Lu ZX, Sikaris KA, et al. Cystatin C estimated glomerular filtration rate and all-cause and cardiovascular disease mortality risk in the general population: AusDiab study. Nephrology. (2017) 22:243–50. 10.1111/nep.12759 - DOI - PubMed
    1. Li W, Zhao JQ, Song L, Chen SH, Liu XM, Wu SL. Combined effects of carotid plaques and hypertension on the risk of cardiovascular disease and all-cause mortality. Clin Cardiol. (2020) 43:715–22. 10.1002/clc.23372 - DOI - PMC - PubMed
    1. Buyadaa O, Magliano DJ, Salim A, Koye DN, Shaw JE. Risk of rapid kidney function decline, all-cause mortality, and major cardiovascular events in nonalbuminuric chronic kidney disease in type 2 diabetes. Diabetes Care. (2020) 43:122–9. 10.2337/dc19-1438 - DOI - PMC - PubMed
    1. Song PG, Xia W, Zhu YJ, Wang ML, Chang XL, Jin S, et al. Prevalence of carotid atherosclerosis and carotid plaque in Chinese adults: a systematic review and meta-regression analysis. Atherosclerosis. (2018) 276:67–73. 10.1016/j.atherosclerosis.2018.07.020 - DOI - PubMed