Syncope and Collapse Are Associated with an Increased Risk of Cardiovascular Disease and Mortality in Patients Undergoing Dialysis

Shih-Ting Huang, Tung-Min Yu, Tai-Yuan Ke, Ming-Ju Wu, Ya-Wen Chuang, Chi-Yuan Li, Chih-Wei Chiu, Cheng-Li Lin, Wen-Miin Liang, Tzu-Chieh Chou and Chia-Hung Kao
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Shih-Ting Huang: Division of Nephrology, Taichung Veterans General Hospital, Taichung 407, Taiwan
Tung-Min Yu: Division of Nephrology, Taichung Veterans General Hospital, Taichung 407, Taiwan
Tai-Yuan Ke: Division of Nephrology, Ministry of Health and Welfare Chiayi Hospital, Chiayi 600, Taiwan
Ming-Ju Wu: Division of Nephrology, Taichung Veterans General Hospital, Taichung 407, Taiwan
Ya-Wen Chuang: Division of Nephrology, Taichung Veterans General Hospital, Taichung 407, Taiwan
Chi-Yuan Li: Graduate Institute of Clinical Medical Science, China Medical University, Taichung 404, Taiwan
Chih-Wei Chiu: Graduate Institute of Clinical Medical Science, China Medical University, Taichung 404, Taiwan
Cheng-Li Lin: Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
Wen-Miin Liang: Graduate Institute of Biostatistics, China Medical University, Taichung 404, Taiwan
Tzu-Chieh Chou: Department of Public Health, China Medical University, Taichung 404, Taiwan
Chia-Hung Kao: Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan

IJERPH, 2018, vol. 15, issue 10, 1-13

Abstract: Objective : This study explored the impact of syncope and collapse (SC) on cardiovascular events and mortality in patients undergoing dialysis. Methods : Patients undergoing dialysis with SC ( n = 3876) were selected as the study cohort and those without SC who were propensity score-matched at a 1:1 ratio were included as controls. Major adverse cardiovascular events (MACEs), including acute coronary syndrome (ACS), arrhythmia or cardiac arrest, stroke, and overall mortality, were evaluated and compared in both cohorts. Results : The mean follow-up periods until the occurrence of ACS, arrhythmia or cardiac arrest, stroke, and overall mortality in the SC cohort were 3.51 ± 2.90, 3.43 ± 2.93, 3.74 ± 2.97, and 3.76 ± 2.98 years, respectively. Compared with the patients without SC, those with SC had higher incidence rates of ACS (30.1 vs. 24.7 events/1000 people/year), arrhythmia or cardiac arrest (6.75 vs. 3.51 events/1000 people/year), and stroke (51.6 vs. 35.7 events/1000 people/year), with higher overall mortality (127.7 vs. 77.9 deaths/1000 people/year). The SC cohort also had higher risks for ACS, arrhythmia or cardiac arrest, stroke, and overall mortality (adjusted hazard ratios: 1.28 (95% confidence interval (CI) = 1.11–1.46), 2.05 (95% CI = 1.50–2.82), 1.48 (95% CI = 1.33–1.66), and 1.79 (95% CI = 1.67–1.92), respectively) than did the non-SC cohort. Conclusion : SC was significantly associated with cardiovascular events and overall mortality in the patients on dialysis. SC may serve as a prodrome for cardiovascular comorbidities, thereby assisting clinicians in identifying high-risk patients.

Keywords: syncope and collapse; acute coronary syndrome; dialysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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