Evidence map›Paper›PMID 39482658›Full record

ArticleBMC nephrology2024

Carotid plaque thickness predicts cardiovascular events and death in patients with chronic kidney disease.

Sasha S Bjergfelt, Ida M H Sørensen, Laerke Urbak, Klaus F Kofoed, Theis Lange, Bo Feldt-Rasmussen, Henrik Sillesen, Christina Christoffersen, Susanne Bro

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sasha S BjergfeltDepartment of Nephrology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
Ida M H SørensenDepartment of Nephrology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
Laerke UrbakDepartment of Vascular Surgery, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
Klaus F KofoedDepartment of Cardiology and Radiology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, DK- 2100, Denmark.
Theis LangeDepartment of Public Health (Biostatistics), Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, DK-1014, Denmark.
Bo Feldt-RasmussenDepartment of Nephrology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
Henrik SillesenDepartment of Vascular Surgery, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
Christina ChristoffersenDepartment of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, DK-2200, Denmark.
Susanne BroDepartment of Nephrology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, DK-2100, Denmark. Susanne.Bro@regionh.dk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClassical risk scoring systems underestimate the risk of cardiovascular disease in chronic kidney disease (CKD). Coronary artery calcium score (CACS) has improved prediction of cardiovascular events in patients with CKD. The maximal carotid plaque thickness (cPTmax) measured in ultrasound scans of the carotid arteries has demonstrated similar predictive value as CACS in the general population. This is the first study to investigate whether cPTmax can predict cardiovascular events in CKD and to compare the predictive value of cPTmax and CACS in CKD.

methodTwo hundred patients with CKD stage 3 from the Copenhagen CKD Cohort underwent ultrasound scanning of the carotid arteries. The assessment consisted of locating plaque and measuring the thickest part of the plaque, cPTmax. Based on the distribution of cPTmax, the participants were divided into 3 groups: No plaques, cPTmax 1.0-1.9 mm and cPTmax > 1.9 mm (median cPTmax = 1.9 mm among patients with plaques). To measure CACS, 175 of the patients underwent a non-contrast CT scan of the coronary arteries. The follow-up time spanned between the ultrasound scan and a predefined end-date or the time of first event, defined as a composite of major cardiovascular events or death of any cause (MACE).

resultsThe median follow-up time was 5.4 years during which 45 patients (22.5%) developed MACE. In a Cox-regression adjusted for classical cardiovascular risk factors, patients with cPTmax > 1.9 mm had a significantly increased hazard ratio of MACE (HR 3.2, CI: 1.1-9.3), p = 0.031) compared to patients without plaques. C-statistics was used to evaluate models for predicting MACE. The improvement in C-statistics was similar for the two models including classical cardiovascular risk factors plus cPTmax (0.247, CI: 0.181-0.312) and CACS (0.243, CI: 0.172-0.315), respectively, when compared to a model only controlled for time since baseline (a Cox model with no covariates).

conclusionOur results indicate that cPTmax may be useful for predicting MACE in CKD. cPTmax and CACS showed similar ability to predict MACE.

Indexed as

Cardiovascular DiseasesPlaque, AtheroscleroticRenal Insufficiency, ChronicAgedCarotid Artery DiseasesCarotid Intima-Media ThicknessCohort StudiesFemaleHumansMaleMiddle AgedPredictive Value of TestsRisk FactorsCACSCardiovascular eventsCardiovascular riskCarotid ultrasound imagingChronic kidney diseaseCoronary artery calcium scorecPTmaxMACEMaximal carotid plaque thicknessPlaque progression

Identifiers

PMID39482658
PMCPMC11526655

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.