Kidney Week

Abstract: SA-PO925

Gender-Specific Risk of Atheromatous and Non-Atheromatous Cardiovascular Events in CKD

Session Information

• CKD: Observational Research and Patient-Oriented Interventions
  November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

• Faucon, Anne-Laure, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Anne-Laure Faucon,

• Lambert, Oriane, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Oriane Lambert,

• Alencar de Pinho, Natalia, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Natalia Alencar de Pinho,

• Ayav, Carole, Centre hospitalier regional universitaire de Nancy, Nancy, Lorraine, France

Carole Ayav,

• Combe, Christian, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, Aquitaine, France

Christian Combe,

• Fouque, Denis, Department of Nephrology, CHU Lyon Sud, Lyon, France

Denis Fouque,

• Jacquelinet, Christian, Agence de la biomedecine, La Plaine Saint-Denis, Île-de-France, France

Christian Jacquelinet,

• Laville, Maurice, Department of Nephrology, CHU Lyon Sud, Lyon, France

Maurice Laville,

• Liabeuf, Sophie, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, Hauts-de-France, France

Sophie Liabeuf,

• Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Roberto Pecoits-Filho,

• Massy, Ziad, Department of Nephrology, Hopital Ambroise Pare, Boulogne-Billancourt, Ile de France, France

Ziad Massy,

• Mansencal, Nicolas, Department of Cardiology, Hopital Ambroise Pare, Boulogne Billancourt, Île-de-France, France

Nicolas Mansencal,

• Stengel, Benedicte, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Benedicte Stengel,

Group or Team Name

• CKD-REIN study group

Background

The excess risk of atheromatous cardiovascular disease (CVD) in men vs women is well-known in the general population. CKD increases the risks of both atheromatous and non-atheromatous CVD (ACVD, N-ACVD), but gender-related differences in risk by CVD type are poorly documented.

Methods

Among 3033 non-dialysis CKD patients included in the CKD-REIN Cohort (65% men; 67 years; eGFR 33 mL/min/1.73m²), we reviewed all hospitalization and death reports for CV events. Using criteria from the Cardiovascular and Stroke Endpoint Definitions for Clinical Trials, these were classified into fatal and non-fatal ACVD (coronary, cerebral, lower limb artery diseases) and N-ACVD (heart failure, atrial fibrillation). Cause-specific Cox models were used to estimate adjusted hazard ratios for CV death, ACVD and N-ACVD according to gender.

Results

At baseline, the prevalence of ACVD was higher in men (46%) than in women (28%), and slightly higher for N-ACVD (33% vs 27%). During a median follow-up of 4.6[IQR 2.8;5.0] years, 98 (5.0%) men and 43 (4.1%) women died from CVD. The crude risk for ACVD was significantly higher in men than in women, but not that for N-ACVD events and CV death (Figure). Kidney function was more strongly associated with N-ACVD than with ACVD, similarly in both genders. After adjusting for age, CV risk factors, and kidney function, the excess risk of ACVD associated with men was on the borderline of significance, HR: 1.33[1.00;177]; there was none for CV death, 0.93[0.58;1.50] and N-ACVD, 0.92[0.71;1.20].

Conclusion

In CKD patients, the burden of ACVD is higher in men than in women, and largely explained by their higher prevalence of CV risk factors. In contrast, the risk of N-ACVD appears to be similar in both genders and closely associated with kidney function, suggesting a more prominent role of CKD specific risk factors including volume disorders and uremic toxins.