國家衛生研究院 NHRI:Item 3990099045/12051
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/12051


    Title: Temporal distribution and biological determinants of thrombotic events after interventions for dialysis vascular access
    Authors: Hsieh, MY;Lee, CK;Lo, CM;Chen, CH;Chuang, SY;Wu, CC
    Contributors: Institute of Population Health Sciences
    Abstract: Endovascular therapy is the principal therapy for haemodialysis vascular access dysfunction. Nonetheless, the incidence and determinants of post-intervention thrombotic events are unclear. This prospective cohort study evaluated the incidence and timing of thrombotic events after endovascular therapy and analysed the clinical, angiographic, and biological determinants of thrombosis. Of the 236 patients enrolled, 91 experienced post-intervention thrombotic events within 1 year. The 1-year thrombosis-free patency was 28% for thrombosed accesses, 53% for non-thrombosed grafts, and 78% for non-thrombosed fistulas. Forty-one of the 91 thrombotic events (45%) occurred within 3 months post-intervention. In the univariate analysis, early thrombosis was associated with longer haemodialysis duration (hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.01-1.02), graft access (HR, 7.69; 95% CI, 3.33-20.0), multiple stenoses (HR, 2.69; 95% CI, 1.36-5.37), and high indoxyl sulphate (IS) levels (HR, 1.55; 95% CI, 1.32-1.82). Late thrombosis was associated with diabetes (HR, 1.89; 95% CI, 1.01-3.57), cardiovascular disease (HR, 2.38; 95% CI, 1.27-4.54), and endothelial progenitor cell counts (HR, 0.97; 95% CI, 0.93-0.99). After multivariate adjustment, high IS was the major predisposing factor for early post-intervention thrombosis (HR, 1.41; 95% CI, 1.18-1.69). Our findings suggest that measures to decrease IS could target the most critical period of thrombosis.
    Date: 2019-07-24
    Relation: Scientific Reports. 2019 Jul 24;9:Article number 10720.
    Link to: http://dx.doi.org/10.1038/s41598-019-47293-3
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2045-2322&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000476874600018
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85069643260
    Appears in Collections:[Shao-Yuan Chuang] Periodical Articles

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