PMID- 21551022
OWN - NLM
STAT- MEDLINE
DCOM- 20110930
LR  - 20211020
IS  - 1555-905X (Electronic)
IS  - 1555-9041 (Print)
IS  - 1555-9041 (Linking)
VI  - 6
IP  - 6
DP  - 2011 Jun
TI  - Inflammatory markers and risk of cerebrovascular events in patients initiating 
      dialysis.
PG  - 1292-300
LID - 10.2215/CJN.08350910 [doi]
AB  - BACKGROUND AND OBJECTIVES: Stroke remains a leading cause of morbidity and 
      mortality for patients on dialysis; however, its risk factors in this population 
      and measures to prevent it are not well understood. DESIGN, SETTING, 
      PARTICIPANTS, & MEASUREMENTS: We investigated whether inflammation was associated 
      with cerebrovascular events in a national US cohort of 1041 incident dialysis 
      patients enrolled from October 1995 to June 1998 and followed until January 31, 
      2004. Incident cerebrovascular events were defined as nonfatal (hospitalized 
      stroke, carotid endarterectomy) and fatal (stroke death) events after dialysis 
      initiation. With Cox proportional hazards regression analysis accounting for the 
      competing risk of nonstroke death, we assessed the independent event risk 
      associated with baseline levels of multiple inflammatory markers 
      (high-sensitivity C-reactive protein [hsCRP], interleukin-6 (IL-6), matrix 
      metalloproteinase-3 [MMP-3], and P-selectin) and 
      hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) use, 
      which may have pleiotropic inflammatory effects. RESULTS: 165 patients 
      experienced a cerebrovascular event during 3548 person-years of follow-up; 
      overall incidence rate was 4.9/100 person-years. None of the inflammatory markers 
      were associated with cerebrovascular event risk (adjusted hazard ratios [HRs] per 
      log unit [95% confidence interval]: hsCRP, 0.97 [0.85 to 1.11]; IL-6, 1.04 [0.85 
      to 1.26]; MMP-3, 1.02 [0.70 to 1.48]; P-selectin, 0.98 [0.57 to 1.68]). Statin 
      use was also not associated with significant risk of events in unadjusted (HR 
      1.07 [0.69 to 1.68]) or propensity-score adjusted analyses (HR 0.98 [0.61 to 
      1.56]). CONCLUSIONS: In conclusion, neither inflammatory markers nor statin use 
      was associated with risk of cerebrovascular events. Further studies are needed to 
      understand the pathophysiology and prevention of stroke in patients on dialysis.
FAU - Sozio, Stephen M
AU  - Sozio SM
AD  - Department of Medicine, Division of Nephrology, Johns Hopkins University School 
      of Medicine, Baltimore, MD 21224, USA. ssozio@jhmi.edu
FAU - Coresh, Josef
AU  - Coresh J
FAU - Jaar, Bernard G
AU  - Jaar BG
FAU - Fink, Nancy E
AU  - Fink NE
FAU - Plantinga, Laura C
AU  - Plantinga LC
FAU - Armstrong, Paige A
AU  - Armstrong PA
FAU - Longenecker, J Craig
AU  - Longenecker JC
FAU - Sharrett, A Richey
AU  - Sharrett AR
FAU - Powe, Neil R
AU  - Powe NR
FAU - Parekh, Rulan S
AU  - Parekh RS
LA  - eng
GR  - K24 DK002643/DK/NIDDK NIH HHS/United States
GR  - L30 DK079767/DK/NIDDK NIH HHS/United States
GR  - U01 DK067651/DK/NIDDK NIH HHS/United States
GR  - R21 DK067651/DK/NIDDK NIH HHS/United States
GR  - R01 HL062985/HL/NHLBI NIH HHS/United States
GR  - R01 DK059616/DK/NIDDK NIH HHS/United States
GR  - R01 DK072367/DK/NIDDK NIH HHS/United States
GR  - R01DK059616/DK/NIDDK NIH HHS/United States
GR  - U01DK067651/DK/NIDDK NIH HHS/United States
GR  - R01HS008365/HS/AHRQ HHS/United States
GR  - R01DK072367/DK/NIDDK NIH HHS/United States
GR  - U01 DK057304/DK/NIDDK NIH HHS/United States
GR  - K24DK002643/DK/NIDDK NIH HHS/United States
GR  - KL2 RR025006/RR/NCRR NIH HHS/United States
GR  - R01HL62985/HL/NHLBI NIH HHS/United States
GR  - U01DK057304/DK/NIDDK NIH HHS/United States
GR  - R01 HS008365/HS/AHRQ HHS/United States
GR  - KL2RR025006/RR/NCRR NIH HHS/United States
GR  - R21DK067651/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20110505
PL  - United States
TA  - Clin J Am Soc Nephrol
JT  - Clinical journal of the American Society of Nephrology : CJASN
JID - 101271570
RN  - 0 (Biomarkers)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Inflammation Mediators)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers/blood
MH  - Cerebrovascular Disorders/*etiology/immunology/mortality
MH  - Female
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
MH  - Incidence
MH  - Inflammation/*etiology/immunology/mortality
MH  - Inflammation Mediators/*blood
MH  - Kidney Failure, Chronic/complications/immunology/mortality/*therapy
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Nonlinear Dynamics
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Renal Dialysis/*adverse effects/mortality
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
PMC - PMC3109924
EDAT- 2011/05/10 06:00
MHDA- 2011/10/01 06:00
PMCR- 2012/06/01
CRDT- 2011/05/10 06:00
PHST- 2011/05/10 06:00 [entrez]
PHST- 2011/05/10 06:00 [pubmed]
PHST- 2011/10/01 06:00 [medline]
PHST- 2012/06/01 00:00 [pmc-release]
AID - CJN.08350910 [pii]
AID - 08350910 [pii]
AID - 10.2215/CJN.08350910 [doi]
PST - ppublish
SO  - Clin J Am Soc Nephrol. 2011 Jun;6(6):1292-300. doi: 10.2215/CJN.08350910. Epub 
      2011 May 5.