BACKGROUND: Non-high-density lipoprotein cholesterol (non-HDL-C) has been proposed as a predictor of cardiovascular disease (CVD) in the general population. The aim of this study was to evaluate the utility of non-HDL-C in predicting CV mortality in chronic hemodialysis (HD) patients. METHODS: We calculated the serum non-HDL-C level of 259 HD patients by subtracting their HDL-C levels from their total cholesterol. Cox proportional hazards models were used to estimate the hazards ratio (HR) for CV mortality and the 95% confidence interval (CI). A receiver-operating characteristic (ROC) analysis was performed to estimate the relationship between sensitivity and specificity of a diagnostic parameter. RESULTS: There were 44 deaths (17.0%) during the follow-up period, 33 (12.7%) of which were due to CVD. A multivariate Cox analysis with adjustments for age, diabetes, dialysis vintage, systolic blood pressure, serum albumin, and lipid levels showed that non-HDL-C was an independent predictor of CV mortality (HR 1.015, 95% CI 1.004-1.025, p = 0.0083). An ROC analysis showed that the plots of the non-HDL-C levels yielded significant specificity and sensitivity for predicting the risk of CVD mortality in HD patients [area under the curve (AUC) 0.62416; p = 0.0366; cutoff value 111.0 mg/dl]. The Kaplan-Meier survival curves of HD patients showed significant differences in CV mortality according to their tertiles with respect to serum non-HDL-C levels (p = 0.0165). CONCLUSION: The results of this study suggest that serum non-HDL-C level is a significant CV mortality predictor of chronic HD patients.
BACKGROUND: Non-high-density lipoprotein cholesterol (non-HDL-C) has been proposed as a predictor of cardiovascular disease (CVD) in the general population. The aim of this study was to evaluate the utility of non-HDL-C in predicting CV mortality in chronic hemodialysis (HD) patients. METHODS: We calculated the serum non-HDL-C level of 259 HDpatients by subtracting their HDL-C levels from their total cholesterol. Cox proportional hazards models were used to estimate the hazards ratio (HR) for CV mortality and the 95% confidence interval (CI). A receiver-operating characteristic (ROC) analysis was performed to estimate the relationship between sensitivity and specificity of a diagnostic parameter. RESULTS: There were 44 deaths (17.0%) during the follow-up period, 33 (12.7%) of which were due to CVD. A multivariate Cox analysis with adjustments for age, diabetes, dialysis vintage, systolic blood pressure, serum albumin, and lipid levels showed that non-HDL-C was an independent predictor of CV mortality (HR 1.015, 95% CI 1.004-1.025, p = 0.0083). An ROC analysis showed that the plots of the non-HDL-C levels yielded significant specificity and sensitivity for predicting the risk of CVD mortality in HDpatients [area under the curve (AUC) 0.62416; p = 0.0366; cutoff value 111.0 mg/dl]. The Kaplan-Meier survival curves of HDpatients showed significant differences in CV mortality according to their tertiles with respect to serum non-HDL-C levels (p = 0.0165). CONCLUSION: The results of this study suggest that serum non-HDL-C level is a significant CV mortality predictor of chronic HDpatients.
Authors: Christoph Wanner; Vera Krane; Winfried März; Manfred Olschewski; Johannes F E Mann; Günther Ruf; Eberhard Ritz Journal: N Engl J Med Date: 2005-07-21 Impact factor: 91.245
Authors: Alexander S Goldfarb-Rumyantzev; Arsalan N Habib; Bradley C Baird; Lev L Barenbaum; Alfred K Cheung Journal: Am J Kidney Dis Date: 2007-11 Impact factor: 8.860
Authors: Christoph Wanner; Vera Krane; Winfried März; Manfred Olschewski; Hans-Gernot Asmus; Walter Krämer; Karl-Wilhelm Kühn; Heinrich Kütemeyer; Johannes F E Mann; Günther Ruf; Eberhard Ritz Journal: Kidney Blood Press Res Date: 2004-08-16 Impact factor: 2.687