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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
A plain X-ray vascular calcification score is associated with arterial stiffness and mortality in dialysis patients
Teresa Adragão1, Ana Pires, Rita Birne
1Nefroclínica Estoril, Diaverum, Estoril, Portugal. tadragao@netcabo.pt
Insights
Simple vascular calcification scores (SVCS) and pulse pressure (PP) can predict mortality risk in dialysis patients. These inexpensive methods offer valuable insights for guiding treatment interventions and assessing arterial stiffness.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Vascular calcifications and arterial stiffness are common in dialysis patients, increasing mortality risk.
- Simple, cost-effective methods for assessing these conditions are needed.
- This study investigates a simple vascular calcification score (SVCS) and its relation to arterial stiffness and mortality.
Purpose of the Study:
- To evaluate the relationship between a simple vascular calcification score (SVCS) and pulse wave velocity (PWV) and pulse pressure (PP).
- To assess the association of SVCS, PWV, and PP with all-cause mortality in hemodialysis patients.
Main Methods:
- 101 hemodialysis patients were assessed for arterial stiffness using PP and PWV.
- A simple vascular calcification score (SVCS) was determined from plain X-rays of the pelvis and hands.
- Patient survival was monitored over a 43-month period.
Main Results:
- Higher SVCS, PP, and PWV were significantly associated with reduced cumulative survival.
- SVCS and PP remained significant predictors of mortality after adjusting for multiple variables.
- SVCS was independently associated with PWV and PP, indicating its link to arterial stiffness.
Conclusions:
- Simple vascular calcification score (SVCS), pulse pressure (PP), and pulse wave velocity (PWV) are associated with increased mortality in dialysis patients.
- SVCS demonstrates a correlation with arterial stiffness, suggesting its utility in risk assessment.
- Inexpensive methods like SVCS and PP can aid in identifying mortality risk and informing therapeutic strategies in dialysis patients.
Background:
Vascular calcifications are highly prevalent in dialysis patients and are associated with arterial stiffness and mortality. The use of simple and inexpensive methods to evaluate arterial stiffness and vascular calcifications is desired. The objective of this study was to evaluate the relationship of a simple vascular calcification score (SVCS) with pulse wave velocity (PWV) and pulse pressure (PP) and to evaluate their association with all-cause mortality.
Methods:
101 haemodialysis patients (71 men; 19% diabetic) were evaluated. At baseline, arterial stiffness was measured by PP and by PWV with Complior. SVCS was evaluated in plain X-ray of pelvis and hands.
Results:
During a 43-month observational period, 31 patients died. By Kaplan-Meier analysis, SVCS >3 (P = 0.001), PP > 70 mmHg (P = 0.001) and PWV > 10.5 m/s (P < 0.001) were found to be associated with lower cumulative survival. Adjusting for multiple variables, association with mortality was maintained for SVCS >3 (HR = 3.308, P = 0.032) and PP > 70 mmHg (HR = 3.227, P = 0.031) in all patients and for PWV > 10.5 m/s (HR = 2.981, P = 0.047) in non-diabetic patients. Age (P < 0.001), systolic pressure (P = 0.004) and SVCS > 3 (P = 0.032) were associated with PWV. Diabetes (P = 0.031), calcium carbonate dose (P = 0.009) and SVCS > 3 (P = 0.012) were associated with PP.
Conclusion:
Higher SVCS, PWV and PP were associated with higher mortality in this population. SVCS was associated with arterial stiffness. Simple and inexpensive methods such as PP or SVCS may be used to detect mortality risk and to provide important information that may be relevant for guiding therapeutic intervention in dialysis patients.
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