Impact of calculated plasma volume status on all-cause and cardiovascular mortality: 4-year nationwide community-based prospective cohort study

• Published in: PloS one 2020-08, Vol.15 (8), p.e0237601-e0237601
• Main Authors: Otaki, Yoichiro, Watanabe, Tetsu, Konta, Tsuneo, Watanabe, Masafumi, Asahi, Koichi, Yamagata, Kunihiro, Fujimoto, Shouichi, Tsuruya, Kazuhiko, Narita, Ichiei, Kasahara, Masato, Shibagaki, Yugo, Iseki, Kunitoshi, Moriyama, Toshiki, Kondo, Masahide, Watanabe, Tsuyoshi
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Blood plasma; Blood pressure; Blood tests; Cardiology; Cardiovascular diseases; Cholesterol; Cohort analysis; Congestive heart failure; Contraction; Diabetes; Diagnosis; Ethics; Fatalities; Health aspects; Health care policy; Health risks; Heart failure; Kidney diseases; Laboratories; Medicine; Medicine and Health Sciences; Metabolic disorders; Mortality; Nephrology; Patient outcomes; Plasma; Population; Pulmonary arteries; Reclassification; Regression analysis; Risk analysis; Risk assessment; Risk factors; Statistical analysis; Studies; Supervision; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0237601

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 [greater than or equal to] 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.