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Abstract: SA-PO162

Breast Artery Calcification as a Surrogate Marker for Vascular Calcification in CKD

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Mueangpaisarn, Pattranid, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Tasanavipas, Pamila, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Siriwattanasit, Narongrit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Inkong, Pitchamon, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Varothai, Narittaya, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Thimachai, Paramat, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Tangwonglert, Theerasak, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Kaewput, Wisit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Supasyndh, Ouppatham, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao College of Medicine, Bangkok, Thailand
Background

Arterial calcification is common in patients with chronic kidney disease and contributes to excess cardiovascular mortality. Breast artery calcification could be a potential marker of medial vascular calcification in CKD but is limited for screening vascular calcification in patients with CKD. The study aimed to determine the performance of BAC for detecting vascular calcification in CKD patients and investigate the relationship between BAC and associated factors in CKD patients.

Methods

A total of 103 women aged>40 years with estimated glomerular filtration rate (GFR) of less than 90 ml/mL/min/1.73 m2 with digital mammography, lateral lumbar spine radiographs, and non-contrast computed tomography was included. BAC score (0-12) was calculated by the number of calcified vessels, the longest length and the density of calcification. Cardiovascular disease risk factors and laboratory profiles were assessed for each patient.

Results

BAC was identified 8 (39.1%) in CKD stage II, 26 (56.5%) in CKD stage III, and 26 (76.5%) in CKD stage IV-V (P<0.017). Patients with the presence BAC were significantly older, had lower GFR, higher hemoglobinA1C and increased AAC score than patients without calcification. In a multivariate model including the traditional cardiovascular risk factors, the presence of BAC was significantly associated with lower estimated GFR (adjusted HR=5.67, 95%CI 1.78-17.83) and older age (adjusted HR:1.009, 95%CI 1.02-1.17). BAC increased in sensitivity (85.7%) and accuracy (67.6%) in accordance with coronary artery calcification score (CAC) in patients with GFR less than 30 mL/min/1.73 m2. BAC and AAC scores showed significant implications of CAC score in which area under curve (AUC) were 0.67 (95%CI 0.57- 0.78) and 0.84 (95%CI 0.76-0.92), respectively. Remarkably, the combination of AAC and BAC scores showed better CAC score prediction (AUC 0.88, 95%CI 0.81-0.96).

Conclusion

The presence and severity of BAC is markedly increased in advanced CKD and it is significantly associated with older age and lower GFR. A combination of BAC and AAC performed good performance in predicting coronary calcification, especially in advanced CKD.