Association between estimated pulse wave velocity and in-hospital and one-year mortality of patients with chronic kidney disease and atherosclerotic heart disease: a retrospective cohort analysis of the MIMIC-IV database

• Published in: Renal failure Vol. 46; no. 2; p. 2387932
• Main Authors: Cui, Xinhai, Shi, Huishan, Hu, Yuanlong, Zhang, Zhiyuan, Lu, Mengkai, Wu, Jibiao, Li, Chao
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01-12-2024; Taylor & Francis Group
• Subjects: Aged; Atherosclerosis - mortality; atherosclerotic heart disease; chronic kidney disease; Chronic Kidney Disease and Progression; Critical Illness - mortality; Databases, Factual; Estimated pulse wave velocity; Female; Hospital Mortality; Humans; in-hospital mortality; Kaplan-Meier Estimate; Male; Middle Aged; MIMIC-IV database; one-year mortality; Proportional Hazards Models; Pulse Wave Analysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - mortality; Renal Insufficiency, Chronic - physiopathology; Retrospective Studies; Risk Factors; MIMIC-IV database; in-hospital mortality; chronic kidney disease; atherosclerotic heart disease; Estimated pulse wave velocity; one-year mortality
• ISSN: 0886-022X; 1525-6049; 1525-6049
• DOI: 10.1080/0886022X.2024.2387932

Carotid-femoral pulse wave velocity has been identified as an autonomous predictor of cardiovascular mortality and kidney injury. This important clinical parameter can be non-invasively estimated using the calculated pulse wave velocity (ePWV). The objective of this study was to examine the correlation between ePWV and in-hospital as well as one-year mortality among critically ill patients with chronic kidney disease (CKD) and atherosclerotic heart disease (ASHD).
This study included a cohort of 1173 patients diagnosed with both CKD and ASHD, sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The four groups divided into quartiles according to ePWV were compared using a Kaplan-Meier survival curve to assess variations in survival rates. Cox proportional hazards models were employed to analyze the correlation between ePWV and in-hospital as well as one-year mortality among critically ill patients with both CKD and ASHD. To further investigate the dose-response relationship, a restricted cubic splines (RCS) model was utilized. Additionally, stratification analyses were performed to examine the impact of ePWV on hospital and one-year mortality across different subgroups.
The survival analysis results revealed a negative correlation between higher ePWV and survival rate. After adjusting for confounding factors, higher ePWV level (ePWV > 11.90 m/s) exhibited a statistically significant association with an increased risk of both in-hospital and one-year mortality among patients diagnosed with both CKD and ASHD (HR = 4.72, 95% CI = 3.01-7.39,
 < 0.001; HR = 2.04, 95% CI = 1.31-3.19,
 = 0.002). The analysis incorporating an RCS model confirmed a linear escalation in the risk of both in-hospital and one-year mortality with rising ePWV values (
for nonlinearity = 0.619;
for nonlinearity = 0.267).
The ePWV may be a potential marker for the in-hospital and one-year mortality assessment of CKD with ASHD, and elevated ePWV was strongly correlated with an elevated mortality risk in patients diagnosed with both CKD and ASHD.