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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Role of coronary artery calcification score on the decrease in GFR among subjects with CT coronary angiography
Jae Hyun Chang1, Ji Yoon Sung, Hee Eun Nam
1Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
Insights
Higher coronary artery calcification scores (CACS) are linked to a faster annual decline in estimated glomerular filtration rate (GFR). This finding suggests CACS may predict renal disease progression in patients undergoing coronary angiography.
Area of Science:
- Cardiology
- Nephrology
- Radiology
Background:
- Elevated coronary artery calcification score (CACS) correlates with cardiovascular mortality and reduced glomerular filtration rate (GFR).
- The impact of CACS on renal disease progression remains unclear.
Purpose of the Study:
- To investigate the association between CACS and the rate of GFR decline in patients without dialysis.
- To determine if CACS predicts worsening kidney function over time.
Main Methods:
- Evaluated estimated GFR changes in 279 non-dialysis outpatients over a mean follow-up of 13.1 months.
- Coronary computed tomographic angiography was used to assess CACS.
- Statistical analysis adjusted for age, gender, baseline GFR, albumin, and proteinuria.
Main Results:
- Patients with CACS > 200 AU showed a lower final GFR and a higher annual GFR reduction rate compared to those with CACS ≤ 200 AU.
- High CACS independently associated with an increased annual GFR reduction rate (r = -0.142, P = .048) after adjustments.
- No significant difference in baseline GFR was observed between the two CACS groups.
Conclusions:
- CACS is associated with an annual decrease in GFR.
- Elevated CACS may serve as a predictor for accelerated GFR decline in patients requiring coronary computed tomographic angiography.
Objective:
Higher levels of coronary artery calcification score (CACS) are associated not only with an increased risk for cardiovascular death, but also with lower glomerular filtration rates (GFRs). However, its role in renal disease progression in patients has not been elucidated.
Materials And Methods:
We evaluated the change of estimated GFR in 279 nondialytic outpatients, who had undergone computed tomographic coronary angiography and follow-up over a period of 3 months.
Results:
The mean age of the participants was 57.7 ± 10.5 years, and the mean GFR was 88.2 ± 15.7 mL/min/1.73 m(2). Although there was no difference in baseline GFR between the CACS ≤ 200 AU group (n = 240) and the CACS > 200 AU group (n = 39), the latter group had a lower level of final GFR and higher annual reduction rate of GFR than the former group after an observation period of 13.1 ± 5.97 months. After adjusting for confounding variables, including age, gender, baseline GFR, albumin, and proteinuria, high levels of CACS showed an independent association with an annual reduction rate of GFR (r = -0.142, P = .048).
Conclusions:
The results suggest that CACS was related to an annual decrease in GFR and may predict the faster decline in GFR in patients with symptoms requiring computed tomographic coronary angiography.
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