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Abstract: FR-PO1036

Association of Coronary Artery Calcification Density, Coronary Artery Calcification Score, and Cardiovascular Risk in Maintenance Hemodialysis Patients

Session Information

Category: Hypertension and CVD

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

Authors

  • Nishizawa, Yoshiko, Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Mizuiri, Sonoo, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Yamashita, Kazuomi, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Shigemoto, Kenichiro, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Masaki, Takao, Hiroshima University, Hiroshima, Japan
Background

Agatston’s coronary artery calcification score (CACS) is a composite of coronary artery calcification (CAC) volume and CAC density (CACD). In general population, CAC volume is positively and CACD is inversely associated with cardiovascular disease (CVD) events. This study aimed to evaluate the association of CACD, CACS and cardiovascular disease (CVD) in MHD patients.

Methods

The subjects were Japanese MHD patients. CACD, CACS, laboratory parameters were assessed at baseline. The subjects were stratified into CACD and CACS level tertiles (T1–T3), respectively and assessed by Kruskal-Wallis test. Regression analyses for CACD were examined in MHD patients with and without CVD, respectively. Independent variables were age, sex, dialysis vintage, diabetes, current smoker, systolic blood pressure (SBP), serum magnesium, phosphate, uric acid, C-reactive protein (CRP), β2-microglobulin, albumin adjusted-serum calcium, and geriatric nutritional risk index (GNRI).

Results

Among all 291 patients (diabetes: 37.8%, past or present CVD: 39.9%), the mean age and dialysis vintage were 66±13 years, and 104±90 months. The CACD values for T1 (n=97), T2 (n=98), and T3 (n=96), were <3.67, 3.67-3.92, and >3.92. The CACS values for T1, T2, T3, were T1 (n=95), T2 (n=98), and T3 (n=98), were <380.0, 380.0-1931.0, and>1931.0. Multivariate regression analysis for CACD showed that age [β 0.30, 95% CI (0.02-0.03)], diabetes [β 0.31, 95% CI (0.39-0.80)], dialysis vintage [β 0.24, 95% CI (0.00-0.01)], β2-microglobulin [β 0.12, 95% CI (0.01-0.03)] and albumin adjusted-serum calcium [β 0.16, 95% CI (0.08-0.42)] were significantly related factors (P<0.001), but not CVD. Multivariate logistic regression for CVD showed that the highest CACS group [OR 1.9, 95% CI (0.94-3.98)], current smoker [OR2.19, 95% CI (1.22-3.99)], SBP [OR1.03, 95% CI (1.01-1.04)], and serum magnesium [OR 2.91, 95% CI (1.16-7.63)], CRP [OR0.73, 95% CI (0.53-0.95)], β2-microglobulin [OR0.97, 95% CI (0.93-1.02)] and GNRI [OR1.07, 95% CI (1.02-1.13)] were significantly related factors (P<0.05), but not CACD.

Conclusion

In MHD patients, presence of CVD is positively associated with CACS and hypomagnesemia, but not with CACD.