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Abstract: TH-PO909

High Coronary Artery Calcium Score Is Associated with an Increased Risk of Death in Patients Evaluated for Kidney Transplant

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Sarabu, Nagaraju, University Hospitals, Cleveland, Ohio, United States
  • Chalicheemala, Yasolatha, University Hospitals, Cleveland, Ohio, United States
  • Yerneni, Himabindu, University Hospitals, Cleveland, Ohio, United States
  • Jittirat, Arksarapuk, University Hospitals, Cleveland, Ohio, United States
  • Al-Kindi, Sadeer, University Hospitals, Cleveland, Ohio, United States
  • Adonteng-Boateng, Percy, University Hospitals, Cleveland, Ohio, United States
Background

Coronary artery calcification (CAC) is a marker of coronary artery disease which is related to increased risks of cardiovascular complication in kidney transplant recipients. Over the past 5 years, our transplant center has utilized CAC score for cardiac risk stratification in pre-evaluation of kidney transplant. This is a single center, retrospective observational study to evaluate the association between CAC score and death from any cause among kidney transplant (KT) evaluations.

Methods

Retrospective observational study including adults, > 40 years, evaluated for a KT between January 1, 2018, and December 31, 2022. All-cause mortality was ascertained through electronic medical records and the Ohio death index. CAC scores were grouped into low (0-100), medium (100-400), and high (>400). Cox proportional hazard models were used to explore the relationship between CAC score and the mortality.

Results

Of the 570 subjects included, 345 (60%) were male, 272 (48%) were of white race, and 245 (43%) were black. The mean age was 57.8 years. CAC scores were: 247 (43%) low, 91(16%) medium, and 232 (41%) high. The median follow-up for the entire cohort was 22.4 months (IQR 21.4 months). During the study period, 71(12.4%) received kidney transplants, and 67(11.7%) died. Multivariate Cox model showed high CAC score (> 400) was associated with a high hazard of death (HR 3.29, 95% CI: 1.71-6.32).

Conclusion

High CAC score is independently associated with death from any cause in patients evaluated for a kidney transplant. Transplant centers should consider closely monitoring patients with high CAC scores to ensure better performance in the Organ Procurement and Transplant Network metric of waitlist mortality.

Kaplan-Meier Curves of Death from Any Cause by Coronary Artery Calcium (CAC) Score Categories