Nassib Abou Heidar1, Omar Chehab2,3, Rami Z Morsi4, Joseph Elias5, Christopher El Mouhayyar6, Amjad Kanj7, Mustafa Ajam7, Abdallah Haykal7, Mohit Pahuja7, Habib Dakik5, Diane Levine7, Nashat Imran7,8, Aiden Abidov7,9. 1. Division of Urology, Department of Surgery, American University of Beirut, Beirut, Lebanon. 2. Department of Medicine, Detroit Medical Center, Wayne State University, 3990 John R., Detroit, MI, 48201, USA. omar.chehab@wayne.edu. 3. Department of Medicine, Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. omar.chehab@wayne.edu. 4. Department of Neurology, University of Chicago, Chicago, IL, USA. 5. Cardiology Division, Department of Medicine, American University of Beirut, Beirut, Lebanon. 6. Department of Medicine, St Elizabeth Medical Center, Boston, MA, USA. 7. Department of Medicine, Detroit Medical Center, Wayne State University, 3990 John R., Detroit, MI, 48201, USA. 8. Nephrology Division, Department of Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA. 9. Department of Medicine, Cardiology Section, John D. Dingell VA Medical Center, Detroit, MI, USA.
Abstract
PURPOSE: Data on the epidemiology of cardiovascular diseases (CVD) in patients with autosomal dominant polycystic kidney disease (ADPKD) are limited. In this study, we assess the prevalence of CVD in patients with ADPKD and evaluate associations between these two entities. METHODS: Using the National Inpatient Sample database, we identified 71,531 hospitalizations among adults aged ≥ 18 years with ADPKD, from 2006 to 2014 and collected relevant clinical data. RESULTS: The prevalence of CVD in the study population was 42.6%. The most common CVD were ischemic heart diseases (19.3%), arrhythmias (14.2%), and heart failure (13.1%). The prevalence of CVD increased with the severity of renal dysfunction (RD). We found an increase in hospitalizations of patients with ADPKD and CVD over the years (ptrend < 0.01), irrespective of the degree of RD. CVD was the greatest independent predictor of mortality in these patients (OR: 3.23; 95% CI 2.38-4.38 [p < 0.001]). In a propensity matched model of hospitalizations of patients with CKD with and without ADPKD, there was a significant increase in the prevalence of atrial fibrillation/flutter (AF), pulmonary hypertension (PHN), non-ischemic cardiomyopathy (NICM), and hemorrhagic stroke among patients with ADPKD when compared to patients with similar degree of RD without ADPKD. CONCLUSIONS: The prevalence of CVD is high among patients with ADPKD, and the most important risk factor associated with CVD is severity of RD. We found an increase in the trend of hospitalizations of patients with ADPKD associated with increased risk of AF, PHN, NICM, and hemorrhagic stroke. History of CVD is the strongest predictor of mortality among patients with ADPKD.
PURPOSE: Data on the epidemiology of cardiovascular diseases (CVD) in patients with autosomal dominant polycystic kidney disease (ADPKD) are limited. In this study, we assess the prevalence of CVD in patients with ADPKD and evaluate associations between these two entities. METHODS: Using the National Inpatient Sample database, we identified 71,531 hospitalizations among adults aged ≥ 18 years with ADPKD, from 2006 to 2014 and collected relevant clinical data. RESULTS: The prevalence of CVD in the study population was 42.6%. The most common CVD were ischemic heart diseases (19.3%), arrhythmias (14.2%), and heart failure (13.1%). The prevalence of CVD increased with the severity of renal dysfunction (RD). We found an increase in hospitalizations of patients with ADPKD and CVD over the years (ptrend < 0.01), irrespective of the degree of RD. CVD was the greatest independent predictor of mortality in these patients (OR: 3.23; 95% CI 2.38-4.38 [p < 0.001]). In a propensity matched model of hospitalizations of patients with CKD with and without ADPKD, there was a significant increase in the prevalence of atrial fibrillation/flutter (AF), pulmonary hypertension (PHN), non-ischemic cardiomyopathy (NICM), and hemorrhagic stroke among patients with ADPKD when compared to patients with similar degree of RD without ADPKD. CONCLUSIONS: The prevalence of CVD is high among patients with ADPKD, and the most important risk factor associated with CVD is severity of RD. We found an increase in the trend of hospitalizations of patients with ADPKD associated with increased risk of AF, PHN, NICM, and hemorrhagic stroke. History of CVD is the strongest predictor of mortality among patients with ADPKD.
Authors: Maulin M Patel; Amanda R Behar; Robert Silasi; Girija Regmi; Christopher L Sansam; Ravi S Keshari; Florea Lupu; Cristina Lupu Journal: J Am Heart Assoc Date: 2018-11-20 Impact factor: 5.501