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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary Artery Calcium Score and Association with Recurrent Nephrolithiasis: The Multi-Ethnic Study of
Ryan S Hsi1, Andrew J Spieker2, Marshall L Stoller3
1Department of Urology, School of Medicine, University of Washington, Seattle, Washington.
Insights
Recurrent kidney stone formation is linked to more severe coronary artery calcification, indicating a higher risk of subclinical coronary atherosclerosis. This finding highlights a potential connection between kidney stones and heart disease.
Area of Science:
- Cardiovascular epidemiology
- Nephrology
- Preventive cardiology
Background:
- Subclinical coronary artery calcification (CAC) predicts cardiovascular events.
- Kidney stone history is linked to carotid atherosclerosis, but its association with CAC is unknown.
Purpose of the Study:
- To investigate the relationship between kidney stone history and prevalent coronary artery calcification (CAC) in the Multi-Ethnic Study of Atherosclerosis (MESA).
Main Methods:
- Analysis of 3,282 MESA participants (2010-2012) using computed tomography for CAC scoring.
- Kidney stone history assessed by self-report; CAC categorized as none, mild, moderate, or severe.
- Cross-sectional analysis adjusted for demographic and dietary factors.
Main Results:
- Recurrent kidney stone formation was associated with moderate-to-severe CAC (OR 1.80) compared to none/mild.
- Recurrent stone formers showed higher CAC score categories (OR 1.44 per category).
- No difference in CAC was observed between single stone formers and non-stone formers.
Conclusions:
- Recurrent kidney stone formation is associated with subclinical coronary atherosclerosis.
- The association is stronger with CAC severity than with CAC presence.
Purpose:
Subclinical coronary artery calcification is an established predictor of cardiovascular events. While a history of kidney stones has been linked to subclinical carotid atherosclerosis, to our knowledge no study has examined its relationship with coronary artery calcification. We studied the association between kidney stone history and prevalent coronary artery calcification in MESA (Multi-Ethnic Study of Atherosclerosis).
Materials And Methods:
MESA is a multisite cohort study of participants 45 to 84 years old without known cardiovascular disease at baseline from 2000 to 2002. Computerized tomography was done in 3,282 participants at followup in 2010 to 2012 to determine coronary artery calcification and kidney stone history was assessed by self-report. Coronary artery calcification scores were categorized as none-0, mild-1 to 99, moderate-100 to 399 or severe-400 or greater. Cross-sectional analysis was performed adjusting for demographic and dietary factors related to kidney stones.
Results:
The prevalence of kidney stone disease history was approximately 9%, mean ± SD participant age was 69.5 ± 9.3 years, 39% of participants were Caucasian, 47% were men and 69% had detectable coronary artery calcification (score greater than 0). No difference in the score was seen between single stone formers and nonstone formers. Recurrent kidney stone formation was associated with moderate or severe calcification on multivariable logistic regression vs none or mild calcification (OR 1.80, 95% CI 1.22-2.67). When coronary artery calcification scores were separated into none, mild, moderate and severe calcification, recurrent stone formation was associated with a higher score category on multivariable ordinal logistic regression (OR 1.44 per category, 95% CI 1.04-2.01).
Conclusions:
Recurrent kidney stone formation is associated with subclinical coronary atherosclerosis. This association appeared stronger with coronary artery calcification severity than with coronary artery calcification presence.
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