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Abstract: FR-PO359

Arterial Stiffness as a Risk Factor for Subclinical Coronary Artery Calcification in Predialysis CKD: From the KNOW-CKD Study

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Hyun, Young Youl, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Sung, Su Ah, Eulji Medical Center, Seoul, Korea (the Republic of)
  • Han, Seung Hyeok, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Soo Wan, Chonnam National University Medical School, Gwangju, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)

Group or Team Name

  • KNOW-CKD Study Investigators
Background

Both arterial stiffness and coronary artery calcification (CAC) are important predictors of cardiovascular disease (CVD) in the general population and in chronic kidney disease (CKD) patients. Recent studies on arterial stiffness and CAC in subjects with preserved renal function have verified the association between the two. However, the relationship is not well evaluated in CKD patients.

Methods

This cross-sectional study analyzed 1,385 predialysis CKD patients from the KNOW-CKD cohort. Participants were divided into four groups according to brachial-ankle pulse wave velocity (baPWV) quartile. Coronary artery calcium score (CACS) were assessed using cardiac computed tomography and CAC was defined as a CACS >100.

Results

CAC prevalence was higher in the higher baPWV groups (6.4%, 9.8%, 23.7%, and 43.8% for the 1st to 4th quartiles of baPWV, respectively, P<0.001). In Tobit regression analyses (Table) that were fully adjusted for traditional and renal cardiovascular risk factors, the CACS ratio comparing the highest and lowest baPWV quartiles was 3.03 (95% CI, 1.59–6.87). Similarly, the OR for CAC in the highest baPWV quartile compared to the lowest quartile was 1.98 (95% CI, 1.09–3.60) in a fully adjusted multivariate logistic model. Results were consistent across analyses with different cutoffs for CAC or with different clinically relevant subgroups.

Conclusion

Increased arterial stiffness measured by high baPWV was associated with CAC in a predialysis CKD cohort. Further studies are required to explore the role of arterial stiffness in the development of CAC and cardiovascular disease in CKD.

Multivariate-adjusted CACS ratios according to baPWV
baPWV quartileModel 1Model 2Model 3
Ratios (95% CI)PRatios (95% CI)PRatios (95% CI)P
1ReferenceReferenceReference
21.29 (0.67–2.50)0.4481.11 (0.59–2.09)0.7401.11 (0.59–2.08)0.745
33.91 (1.99–7.68)<0.0012.08 (1.08–4.01)0.0292.03 (1.05–3.92)0.034
411.76 (5.8–23.84)<0.0013.44 (1.66–7.14)0.0013.03 (1.59–6.87)0.001

Model 1: Adjusted for age and sex; Model 2: Adjusted for model 1 + WHR, systolic blood pressure, diabetes, eGFR, LDL cholesterol, hsCRP, urine protein to creatinine ratio, and current smoking; Model 3: Adjusted for model 2 + calcium, phosphorus, 25-OH-vit D, and intact PTH

Funding

  • Government Support - Non-U.S.