Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD)
Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD). Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD). We investiga...
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Veröffentlicht in: | Kidney international 2003-08, Vol.64 (2), p.579-584 |
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creator | Zoccali, Carmine Mallamaci, Francesca Tripepi, Giovanni Parlongo, Saverio Cutrupi, Sebastiano Benedetto, Frank Antonio Bonanno, Grazia Seminara, Giuseppe Fatuzzo, Pasquale Rapisarda, Francesco Malatino, Lorenzo Salvatore |
description | Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD).
Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD).
We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months).
On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77).
seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. It is highly unlikely that C. pneumoniae infection is a major risk factor in patients with ESRD. |
doi_str_mv | 10.1046/j.1523-1755.2003.00095.x |
format | Article |
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Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD).
We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months).
On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77).
seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. It is highly unlikely that C. pneumoniae infection is a major risk factor in patients with ESRD.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1046/j.1523-1755.2003.00095.x</identifier><identifier>PMID: 12846753</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Antibodies, Bacterial - blood ; Biological and medical sciences ; Cardiovascular Diseases - mortality ; cardiovascular risk ; chlamydia ; Chlamydophila Infections - mortality ; Chlamydophila pneumoniae ; Chlamydophila pneumoniae - immunology ; Cohort Studies ; dialysis ; ESRD ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin A - blood ; Immunoglobulin G - blood ; Kidney Failure, Chronic - mortality ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Renal failure ; Risk Factors ; survival ; Survival Analysis ; uremia</subject><ispartof>Kidney international, 2003-08, Vol.64 (2), p.579-584</ispartof><rights>2003 International Society of Nephrology</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Aug 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-938c3a096ed7e64dfba6481d8e61ce6173baa9b7c2bbfb5e5cbe9d7841f770bd3</citedby><cites>FETCH-LOGICAL-c540t-938c3a096ed7e64dfba6481d8e61ce6173baa9b7c2bbfb5e5cbe9d7841f770bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15005672$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12846753$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zoccali, Carmine</creatorcontrib><creatorcontrib>Mallamaci, Francesca</creatorcontrib><creatorcontrib>Tripepi, Giovanni</creatorcontrib><creatorcontrib>Parlongo, Saverio</creatorcontrib><creatorcontrib>Cutrupi, Sebastiano</creatorcontrib><creatorcontrib>Benedetto, Frank Antonio</creatorcontrib><creatorcontrib>Bonanno, Grazia</creatorcontrib><creatorcontrib>Seminara, Giuseppe</creatorcontrib><creatorcontrib>Fatuzzo, Pasquale</creatorcontrib><creatorcontrib>Rapisarda, Francesco</creatorcontrib><creatorcontrib>Malatino, Lorenzo Salvatore</creatorcontrib><title>Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD)</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD).
Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD).
We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months).
On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77).
seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. It is highly unlikely that C. pneumoniae infection is a major risk factor in patients with ESRD.</description><subject>Adult</subject><subject>Aged</subject><subject>Antibodies, Bacterial - blood</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular Diseases - mortality</subject><subject>cardiovascular risk</subject><subject>chlamydia</subject><subject>Chlamydophila Infections - mortality</subject><subject>Chlamydophila pneumoniae</subject><subject>Chlamydophila pneumoniae - immunology</subject><subject>Cohort Studies</subject><subject>dialysis</subject><subject>ESRD</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Immunoglobulin A - blood</subject><subject>Immunoglobulin G - blood</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Renal failure</subject><subject>Risk Factors</subject><subject>survival</subject><subject>Survival Analysis</subject><subject>uremia</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkV2L1DAUhoMo7uzqX5Ag6CrYMWmaJr3Ucf2ABcGPOyGcJqeaIW3HpB12_r2pM7jghV4ccnGeczh5H0IoZ2vOqvrlds1lKQqupFyXjIk1Y6yR65s7ZPWncZesGNOyKKXQZ-Q8pW2GdCPYfXLGS13VSooV-bb5EaA_OA90N-Dcj4MHfEHHPUYIgcLgqIXo_LiHZOcAkfZjnCD46UD9QHFwRZrgO9KIAwTqfEJISJ9dff705vkDcq-DkPDh6b0gX99efdm8L64_vvuweXVdWFmxqWiEtgJYU6NTWFeua6GuNHcaa25zKdECNK2yZdt2rURpW2yc0hXvlGKtExfk8rh3F8efM6bJ9D5ZDAEGHOdkdNPwqpZlncmn_ySVqOqcZJnBx3-B23GO-YvJlJxxpnRTZUgfIRvHlCJ2Zhd9D_FgODOLKLM1iw-z-DCLKPNblLnJo49O--e2R3c7eDKTgScnIAcPoYswWJ9uOcmYrNVy6OsjhzngvcdokvU4WHQ-op2MG_3_r_kFM_exTA</recordid><startdate>20030801</startdate><enddate>20030801</enddate><creator>Zoccali, Carmine</creator><creator>Mallamaci, Francesca</creator><creator>Tripepi, Giovanni</creator><creator>Parlongo, Saverio</creator><creator>Cutrupi, Sebastiano</creator><creator>Benedetto, Frank Antonio</creator><creator>Bonanno, Grazia</creator><creator>Seminara, Giuseppe</creator><creator>Fatuzzo, Pasquale</creator><creator>Rapisarda, Francesco</creator><creator>Malatino, Lorenzo Salvatore</creator><general>Elsevier Inc</general><general>Nature Publishing</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope></search><sort><creationdate>20030801</creationdate><title>Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD)</title><author>Zoccali, Carmine ; Mallamaci, Francesca ; Tripepi, Giovanni ; Parlongo, Saverio ; Cutrupi, Sebastiano ; Benedetto, Frank Antonio ; Bonanno, Grazia ; Seminara, Giuseppe ; Fatuzzo, Pasquale ; Rapisarda, Francesco ; Malatino, Lorenzo Salvatore</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-938c3a096ed7e64dfba6481d8e61ce6173baa9b7c2bbfb5e5cbe9d7841f770bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antibodies, Bacterial - blood</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular Diseases - mortality</topic><topic>cardiovascular risk</topic><topic>chlamydia</topic><topic>Chlamydophila Infections - mortality</topic><topic>Chlamydophila pneumoniae</topic><topic>Chlamydophila pneumoniae - immunology</topic><topic>Cohort Studies</topic><topic>dialysis</topic><topic>ESRD</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Immunoglobulin A - blood</topic><topic>Immunoglobulin G - blood</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Renal failure</topic><topic>Risk Factors</topic><topic>survival</topic><topic>Survival Analysis</topic><topic>uremia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zoccali, Carmine</creatorcontrib><creatorcontrib>Mallamaci, Francesca</creatorcontrib><creatorcontrib>Tripepi, Giovanni</creatorcontrib><creatorcontrib>Parlongo, Saverio</creatorcontrib><creatorcontrib>Cutrupi, Sebastiano</creatorcontrib><creatorcontrib>Benedetto, Frank Antonio</creatorcontrib><creatorcontrib>Bonanno, Grazia</creatorcontrib><creatorcontrib>Seminara, Giuseppe</creatorcontrib><creatorcontrib>Fatuzzo, Pasquale</creatorcontrib><creatorcontrib>Rapisarda, Francesco</creatorcontrib><creatorcontrib>Malatino, Lorenzo Salvatore</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zoccali, Carmine</au><au>Mallamaci, Francesca</au><au>Tripepi, Giovanni</au><au>Parlongo, Saverio</au><au>Cutrupi, Sebastiano</au><au>Benedetto, Frank Antonio</au><au>Bonanno, Grazia</au><au>Seminara, Giuseppe</au><au>Fatuzzo, Pasquale</au><au>Rapisarda, Francesco</au><au>Malatino, Lorenzo Salvatore</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD)</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2003-08-01</date><risdate>2003</risdate><volume>64</volume><issue>2</issue><spage>579</spage><epage>584</epage><pages>579-584</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD).
Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD).
We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months).
On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77).
seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. It is highly unlikely that C. pneumoniae infection is a major risk factor in patients with ESRD.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12846753</pmid><doi>10.1046/j.1523-1755.2003.00095.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Antibodies, Bacterial - blood Biological and medical sciences Cardiovascular Diseases - mortality cardiovascular risk chlamydia Chlamydophila Infections - mortality Chlamydophila pneumoniae Chlamydophila pneumoniae - immunology Cohort Studies dialysis ESRD Female Follow-Up Studies Humans Immunoglobulin A - blood Immunoglobulin G - blood Kidney Failure, Chronic - mortality Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Renal failure Risk Factors survival Survival Analysis uremia |
title | Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD) |
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