Abstract
Plasma volume status (PVS), a marker of plasma volume expansion and contraction, is gaining attention in the field of cardiovascular disease because of its role in the prevention and of the management of heart failure. However, it remains undetermined whether an abnormal PVS is a risk for all-cause and cardiovascular mortality in the general population. We used a nationwide database of 230,882 subjects (age 40-75 years) who participated in the annual "Specific Health Check and Guidance in Japan" check-up between 2008 and 2011. There were 586 cardiovascular deaths, 2,552 non-cardiovascular deaths, and 3,138 all-cause deaths during the follow-up period of four years. Abnormally high and low PVS were identified from the results of 80% of all subjects (high and low PVS ≥ 7 and < -13.3, respectively). Multivariate Cox proportional hazard regression analysis demonstrated that high PVS was an independent risk factor for all-cause, cardiovascular and non-cardiovascular deaths. Although low PVS was a positive risk factor for cardiovascular deaths as well, it was a negative risk factor for non-cardiovascular deaths. The addition of PVS to cardiovascular risk factors significantly improved the C-statistic, net reclassification, and integrated discrimination indexes. This is the first prospective report to reveal the impact of PVS on all-cause and cardiovascular mortality. PVS could be an additional risk factor for all-cause and cardiovascular mortality in the general population.
Highlights
Regulation of plasma volume is important in pregnancy and is a therapeutic target in sepsis and heart failure [1,2,3]
The addition of Plasma volume status (PVS) to cardiovascular risk factors significantly improved the C-statistic, net reclassification, and integrated discrimination indexes. This is the first prospective report to reveal the impact of PVS on all-cause and cardiovascular mortality
To examine whether model fit and discrimination improve with addition of PVS to the basic predictors such as age, sex, hypertension, dyslipidemia, diabetes mellitus, smoking, and region area, we evaluated the improvement of C index, net reclassification index (NRI) and integrated discrimination index (IDI)
Summary
Regulation of plasma volume is important in pregnancy and is a therapeutic target in sepsis and heart failure [1,2,3]. It was reported that plasma volume calculated using these formulae is a useful predictor of clinical outcome in patients with heart failure [10,11]. Plasma volume status (PVS), a marker of plasma volume expansion and contraction, is gaining attention in the field of cardiovascular disease because of its role in the prevention and of the management of heart failure. It remains undetermined whether an abnormal PVS is a risk for all-cause and cardiovascular mortality in the general population
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