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The prognostic value of abdominal aortic calcification in peritoneal dialysis patients

Hye Eun Yoon1, Bo Geun Park, Hyeon Seok Hwang

  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.

International Journal of Medical Sciences
|April 10, 2013
PubMed

Insights

The aortic calcification index (ACI) predicts cardiovascular events and mortality in peritoneal dialysis (PD) patients. Higher ACI levels indicate increased risk for adverse outcomes, including death and nonfatal cardiovascular events.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Radiology

Background:

  • Cardiovascular disease is a leading cause of mortality in patients undergoing peritoneal dialysis (PD).
  • Abdominal aortic calcification is a marker of systemic atherosclerosis and may predict cardiovascular events.
  • The prognostic value of the aortic calcification index (ACI) in PD patients is not well established.

Purpose of the Study:

  • To evaluate the prognostic value of the ACI, derived from plain abdominal computed tomography (CT), for left ventricular (LV) diastolic dysfunction, mortality, and nonfatal cardiovascular (CV) events in PD patients.
  • To compare the predictive value of ACI with established markers of LV diastolic function, such as the E/E' ratio.

Main Methods:

  • A cohort of PD patients who underwent both abdominal CT and echocardiography was divided into low-ACI and high-ACI groups.
  • Patients were followed for a median of 35.2 months for mortality and nonfatal CV events.
  • Multivariate analyses and receiver operating characteristic (ROC) curve analyses were used to assess the predictive value of ACI.

Main Results:

  • The high-ACI group had significantly lower 5-year event-free survival rates for mortality and CV events compared to the low-ACI group.
  • ACI was positively correlated with LV diastolic dysfunction markers (left atrial diameter and E/E' ratio).
  • High ACI and increased E/E' ratio were independent predictors of mortality and CV events. ACI demonstrated a higher predictive value (AUC = 0.755) than the E/E' ratio (AUC = 0.543).

Conclusions:

  • The ACI is significantly associated with LV diastolic dysfunction in PD patients.
  • The ACI is a valuable independent predictor of all-cause mortality and nonfatal CV events in PD patients.
  • ACI offers superior prognostic value for adverse cardiovascular outcomes compared to the E/E' ratio.
Abstract

Keywords:
Aortic calcificationcardiovascular diseaseleft ventricular diastolic dysfunctionmortalityperitoneal dialysis.

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