Prognostic significance of carotid plaque-presence in peritoneal dialysis patients and its association with the apolipoprotein B/apolipoprotein A1 ratio.

Chen, Yun; Shang, Da; Shao, Jie; Dai, Shuqi; Ge, Xiaolin; Hao, Chuanming; Zhu, Tongying

AIM Atherosclerosis has been reported as a risk factor for cardiovascular disease in the general population. As a phenotype of atherosclerosis, carotid plaque and its influence factors are rarely discussed among dialysis patients. The study aimed to investigate the prognosis-predictive significance of carotid plaques in patients on peritoneal dialysis (PD), and explore risks factors for carotid plaque-presence. METHODS It was an observational, prospective study. Patients that had undergone stable peritoneal dialysis for at least 3 months were recruited and divided into two subgroups: group with carotid plaques and group without carotid plaques. Cox regression model was used to identify independent predictors of all-cause mortality, cardiovascular events and cardiovascular mortality. Pathogenic factors correlated to the plaque-occurrence were explored by logistic regression and verified by receiver operating characteristic curve (ROC) analysis. RESULTS A total of 233 PD patients were recruited. The cohort was followed for up to 86 months. The carotid plaque-presence turned out to be an independent risk factor both of cardiovascular events (HR:2.659; 95%CI: 1.231-5.741; p=0.013) and cardiovascular mortality (HR:3.716; 95%CI: 1.168-11.823; p=0.026). The apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio was significantly associated with the presence of carotid plaques. ROC analysis indicated that the AUC of the ApoB/ApoA1 ratio was higher than that of the traditional lipid metabolism index for detecting plaque-presence. CONCLUSIONS Carotid plaque-presence can predict cardiovascular events and cardiovascular mortality in PD patients. The ApoB/ApoA1 ratio is significantly correlated to the carotid plaques and the ApoB/ApoA1 ratio had a greater sensitivity than traditional lipid indices for predicting plaque presence.