Abstract: TH-PO131
Factors Associated with Coronary Artery Calcification Score in Renal Transplant Recipients
Session Information
- Transplantation: Cardiovascular and Metabolic Diseases
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Lees, Jennifer S., University of Glasgow, Glasgow, United Kingdom
- Rutherford, Elaine, University of Glasgow, Glasgow, United Kingdom
- Roditi, Giles, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
- Jardine, Alan G., University of Glasgow, Glasgow, United Kingdom
- Mark, Patrick B., University of Glasgow, Glasgow, United Kingdom
Background
Coronary artery calcification (CAC) is associated with cardiovascular morbidity. The presence and severity of CAC amongst renal transplant patients may vary because of heterogeneity within the population. We sought to determine factors associated with CAC using baseline data from a clinical trial.
Methods
Prevalent renal transplant patients recruited to a clinical trial of vitamin K supplementation (ViKTORIES: ISRCTN22012044) were included. Biochemical tests were performed and demographic data recorded at the baseline visit. Coronary artery calcification (CAC) was determined by non-contrast CT coronary calcium (Agatston) score; score >160 was considered high. Binary logistic regression analysis was used to determine factors associated with high CAC score. Analyses were conducted using stats and oddsratio for R statistical software.
Results
There were 68 trial participants included: 70.6% were male; 97.1% were Caucasian. Patients with high CAC score (58.8%; median score 1269, IQR 502-3245) were older (60.8 vs 54.7 years; p=0.01) with similar systolic blood pressure (152 vs 144 mmHg; p=0.08) and proteinuria (urine protein creatinine ratio 98 vs 72 mg/mmol; p=0.56), but had longer time since renal transplant (11.2 vs 7.4 years; p=0.05) and time since first renal replacement therapy (17.0 vs 9.8 years; p=0.002). There was no difference in graft function (GFR 50.6 vs 54.2 ml/min; p=0.54) and both groups had controlled calcium, phosphate and parathyroid hormone. Vitamin D insufficiency (vitamin D <30 ng/nl) was common in both groups (71.4 vs 65.0%; p=0.58). On binary logistic regression analysis, factors associated with high CAC score were older age (OR 1.18 per 10-year increase; 95% CI 1.05-1.33), longer duration of non-transplant RRT (OR 1.02 per year; 95% CI 1.01-1.04) and current or previous smoking history (OR 1.35; 95% CI 1.09-1.67).
Conclusion
In a diverse group of renal transplant recipients, high CAC score was associated with older age, dialysis vintage and smoking status, but not with traditional markers of CKD mineral and bone disorder or vitamin D insufficiency. These offer few modifiable risk factors for intervention, though smoking cessation may be worthwhile. Activity of calcification inhibitors may be important in this patient group and warrant further study.
Funding
- Private Foundation Support