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. 2010;31(5):419-25.
doi: 10.1159/000294405. Epub 2010 Apr 9.

Total and individual coronary artery calcium scores as independent predictors of mortality in hemodialysis patients

Ronney S Shantouf  1 , Matthew J Budoff, Naser Ahmadi, Arshia Ghaffari, Ferdinand Flores, Ambarish Gopal, Nazanin Noori, Jennie Jing, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
Affiliations

Total and individual coronary artery calcium scores as independent predictors of mortality in hemodialysis patients

Ronney S Shantouf et al. Am J Nephrol. 2010.

Abstract

Many traditional and nontraditional risk factors contribute to vascular calcification among maintenance hemodialysis (MHD) patients. It is not clear whether coronary artery calcification (CAC) delineates a higher mortality risk independent of known risk factors. We examined 6-year (10/2001-9/2007) survival of 166 MHD patients, aged 53 +/- 13 years, with baseline CAC scores. Patients were grouped into four CAC groups: 0, 1-100, 101-400, and 400+. The 101-400 and 400+ groups were associated with a significantly higher adjusted risk of death than CAC 0 with hazard ratios (HR) 8.5 (95% CI: 1.1-48.1, p = 0.02) and 13.3 (95% CI: 1.3-65.1, p = 0.01), respectively, independent of demographics, comorbidity, lipids and other cardiovascular risks, surrogates of bone disease, nutritional and inflammatory markers and dialysis dose. Total CAC [HR 6.7 (1.1-21.5, p = 0.03)] followed by the presence of CAC in the left main [4.6 (2.2-9.8, p = 0.001)] and left anterior descending artery [4.3 (2.1-14.2, p = 0.001)] were strong independent predictors of mortality even after adjusting for above covariates. Total and vessel-specific CAC predict mortality in MHD patients independent of traditional and nontraditional risk factors.

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Figures

Fig. 1
Fig. 1
Event-free survival among CAC subsets – association between CAC scores and event-free survival across the four groups (CAC 0, CAC 1–100, CAC 101–400, and CAC 400+). Event rates increased from 11.1 to 41.7% as CAC increased across the groups.
See this image and copyright information in PMC

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