Predictive Value of Coronary Calcifications for Future Cardiac Events in Asymptomatic Patients with Severe Chronic Kidney Disease.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2024-11-08 eCollection Date: 2024-11-01 DOI:10.31083/j.rcm2511398

Martin Greif, Korbinian Lackermair, Matthias Wessely, Franz von Ziegler, Alexander Becker

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引用次数: 0

Abstract

Background: Coronary calcification is a well-established risk factor for cardiovascular events. This retrospective study sought to determine the predictive value of coronary calcification in a specific group of patients with chronic kidney disease.

Methods: We included 1094 asymptomatic patients (724 males, 370 females, age 62 ± 9.3 years) referred for cardiological examination. Patents were divided into two groups depending on their renal function. Coronary calcification was determined with a multi-slice computer tomography (CT) scanner. For quantification of coronary calcification the Agatston score was calculated. Over a mean follow up period of 6.2 ± 1.3 years we observed the rate of cardiovascular events (185 events, 61 myocardial infarctions, 103 revascularizations, 21 cardiac deaths).

Results: The calcium score was significantly higher in patients with severe kidney disease (glomerular filtration rate (GFR) ≤30 mL/min/1.72 m²) compared with those with normal to moderate reduced renal function (GFR ≥30 mL/min/1.72 m²) (207 ± 190 vs.121 ± 169, p ≤ 0.001). The event rate in patients with severe impaired renal function was significantly higher compared to patients with normal to moderate reduced renal function (20.6% vs. 14.8%, p = 0.0001). The hazard ratio for cardiovascular events increased constantly with the calcium score in both groups. The hazard ratio in patients with severe kidney disease was significantly lower compared to patients in corresponding groups with regular to moderate reduced renal function (7.3 vs. 9.3, p = 0.01). No cardiac events were observed in patients with a calcium score of 0.

Conclusions: We could demonstrate that risk prediction with the calcium score is possible in patients with severe chronic kidney disease even if the calcium score overestimates the risk for future cardiovascular events compared to patients with normal to moderate reduced renal function.

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冠状动脉钙化对无症状严重慢性肾病患者未来心脏事件的预测价值

背景：冠状动脉钙化是一个公认的心血管事件的危险因素。本回顾性研究旨在确定冠状动脉钙化在特定组慢性肾脏疾病患者中的预测价值。方法：纳入1094例无症状患者，其中男性724例，女性370例，年龄62±9.3岁。患者根据肾功能分为两组。用多层计算机断层扫描（CT）确定冠状动脉钙化。为了量化冠状动脉钙化，计算Agatston评分。在平均6.2±1.3年的随访期间，我们观察到心血管事件发生率（185例事件，61例心肌梗死，103例血运重建术，21例心源性死亡）。结果：重度肾病患者（肾小球滤过率(GFR)≤30 mL/min/1.72 m2）的钙评分明显高于正常至中度肾功能减退患者（GFR≥30 mL/min/1.72 m2）（207±190 vs.121±169,p≤0.001）。严重肾功能受损患者的事件发生率明显高于正常至中度肾功能下降患者（20.6% vs. 14.8%, p = 0.0001）。在两组中，心血管事件的风险比随着钙评分的增加而不断增加。重度肾病患者的危险比明显低于正常至中度肾功能下降组（7.3 vs. 9.3, p = 0.01）。在钙评分为0的患者中未观察到心脏事件。结论：我们可以证明，即使与肾功能正常到中度下降的患者相比，钙评分高估了未来心血管事件的风险，但用钙评分预测严重慢性肾病患者的风险是可能的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.