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Titolo	The association of sudden cardiac death with inflammation and other traditional risk factors
Autore	Rulan S. Parekh1,2,3,4, Laura C. Plantinga3,4, W.H. Linda Kao3,4, Lucy A. Meoni1,4,5, Bernard G. Jaar1,3,4, Nancy E. Fink1,3,4, Neil R. Powe1,3,4,6, Josef Coresh1,3,4,5 and Michael J. Klag1,3,4,6 1Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; 2Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; 3Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; 4Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA; 5Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA and 6Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
Referenza	Kidney International 2008; (74) 1335-1342
Contenuto	Despite the frequency of cardiovascular death in dialysis patients, few studies have prospectively measured sudden cardiac death in these individuals. Here, we sought to determine the frequency of sudden cardiac death and its association with inflammation and other risk factors among the CHOICE (Choices for Healthy Outcomes In Caring for ESRD) cohort of 1,041 incident dialysis patients. Sudden cardiac death was defined as that occurring outside of the hospital with an underlying cardiac cause from death certificate data. Over a median 2.5 years of follow-up, 22% of all mortality in this cohort was due to sudden cardiac death. Using Cox proportional hazards, we found that the highest tertiles of high-sensitivity C-reactive protein and of IL-6 were each associated with twice the risk of sudden cardiac death compared to their lowest tertiles when adjusted for demographics, comorbidities and laboratory factors. A decrement in serum albumin was associated with a 1.35 times increased risk for sudden cardiac death in the highest compared to the lowest tertile. These findings were robust and consistent when accounting for competing risks of death from other causes. Hence, we found that sudden cardiac death is common among patients with end stage renal disease and that inflammation and malnutrition significantly increased its occurrence independent of traditional cardiovascular risk factors.
Data	12.01.2009

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