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Coronary calcification as a predictor of cardiovascular mortality in advanced chronic kidney disease: a prospective

Marta Cano-Megías1, Pablo Guisado-Vasco2, Hanane Bouarich3

  • 1'Principe de Asturias' University Hospital, Ctra Alcalá-Meco s/n. Alcalá de Henares, 28805, Madrid, Spain. mcanomegias@gmail.com.

BMC Nephrology
|May 30, 2019
PubMed

Insights

Severe coronary artery calcification (CaC) significantly increases cardiovascular mortality in advanced chronic kidney disease (CKD) patients over 10 years. CaC is a valuable tool for predicting cardiovascular mortality risk in CKD.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Patients with advanced chronic kidney disease (CKD) have a higher prevalence of coronary artery calcification (CaC).
  • CaC is a potential mortality risk factor in end-stage CKD, but previous studies had short follow-up periods.

Purpose of the Study:

  • To investigate the long-term association between CaC and mortality in advanced CKD patients.
  • To assess CaC as a prognostic tool for cardiovascular (CV) mortality risk in this population.

Main Methods:

  • A 10-year prospective longitudinal cohort study of 137 advanced CKD patients.
  • Coronary computed tomography (CT) was used to assess CaC at baseline, stratified into severe (≥400 HU) and mild-moderate (<400 HU) groups.
  • Overall and CV mortality, CV events, and associated factors were recorded.

Main Results:

  • Overall mortality was 58%, with 40% due to CV events.
  • The severe CaC group had significantly higher overall (75% vs. 30%) and CV mortality (35% vs. 6%) compared to the mild-moderate group (p < 0.001).
  • Severe CaC independently predicted CV mortality (HR 5.01; p=0.02) and was associated with older age, diabetes, prior CV events, and lower albumin.

Conclusions:

  • Severe CaC is associated with significantly increased CV mortality in advanced CKD patients over a 10-year follow-up.
  • Coronary artery calcification scoring can serve as a prognostic indicator for cardiovascular mortality risk in CKD patients.
Abstract

Keywords:
Cardiovascular mortalityChronic kidney diseaseCoronary artery calcificationCoronary calcification scoreHaemodialysis

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