Progression of coronary artery calcification and cardiac events in patients with chronic renal disease not receiving dialysis

We tested for the presence of coronary calcifications in patients with chronic renal disease not on dialysis and studied its progression in 181 consecutive non-dialyzed patients who were followed for a median of 745 days. Coronary calcifications (calcium score) were tallied in Agatston units by comp...

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Bibliographic Details
Published in:	Kidney international Vol. 80; no. 1; pp. 112 - 118
Main Authors:	Russo, Domenico, Corrao, Salvatore, Battaglia, Yuri, Andreucci, Michele, Caiazza, Antonella, Carlomagno, Angelo, Lamberti, Monica, Pezone, Nicoletta, Pota, Andrea, Russo, Luigi, Sacco, Maurizio, Scognamiglio, Bernadette
Format:	Journal Article
Language:	English
Published:	Basingstoke Elsevier Inc 01-07-2011 Nature Publishing Group Elsevier Limited
Subjects:	Adult Aged Biological and medical sciences Calcification (ectopic) Calcinosis - etiology Calcium cardiovascular events chronic kidney disease Cohort Studies Computed tomography coronary artery Coronary Artery Disease - etiology coronary calcification Dialysis Disease Progression Female Heart Humans Kaplan-Meier Estimate Kidney diseases Kidneys Male Medical sciences Middle Aged Myocardial infarction Myocardial Infarction - etiology Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Original Prognosis Renal failure Renal Insufficiency, Chronic - complications Risk Factors Survival Urinary system involvement in other diseases. Miscellaneous cardiovascular events coronary calcification chronic kidney disease Kidney disease Nephrology Urinary system disease Prognosis Coronary artery Cardiovascular disease Chronic kidney disease Urology Renal failure Calcification Evolution Dialysis
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Summary:	We tested for the presence of coronary calcifications in patients with chronic renal disease not on dialysis and studied its progression in 181 consecutive non-dialyzed patients who were followed for a median of 745 days. Coronary calcifications (calcium score) were tallied in Agatston units by computed tomography, and the patients were stratified into two groups by their baseline calcium score (100U or less and over 100U). Survival was measured by baseline calcium score and its progression. Cardiac death and myocardial infarction occurred in 29 patients and were significantly more frequent in those patients with calcium scores over 100U (hazard ratio of 4.11). With a calcium score of 100U or less, the hazard ratio for cardiac events was 0.41 and 3.26 in patients with absent and accelerated progression, respectively. Thus, in non-dialyzed patients, the extent of coronary calcifications was associated to cardiac events, and progression was an independent predictive factor of cardiac events mainly in less calcified patients. Hence, assessment of coronary calcifications and progression might be useful for earlier management of risk factors and guiding decisions for prevention of cardiac events in this patient population.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0085-2538 1523-1755
DOI:	10.1038/ki.2011.69