Coronary Artery Calcification Predicts ACS, Mortality Risks in CKD
Subclinical coronary artery calcification predicts the future risk for acute coronary syndrome (ACS) and mortality among asymptomatic, non-dialysis patients with chronic kidney disease (CKD), according to a recent study.
Findings were presented at the American Society of Nephrology’s Kidney Week 2017, which is taking place from October 31 to November 5, 2017, in New Orleans, Louisiana.
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Vascular calcification is common among patients with CKD and is primarily considered a medial type of arterial calcification, secondary to deranged mineral metabolism due to impaired kidney function. However, studies in the general population have suggested that vascular calcification indicates atherosclerotic burden.
For their study, the researchers evaluated 272 patients with CKD stages 3 to 5 with no known history of coronary artery disease from a university teaching hospital. Mean patient age was 60 years, and 56% of patients were men. Follow-up lasted a mean 69 months.
Coronary artery calcium score (CACS) and blood collection were estimated via plain multi-slice computed tomography scan.
Over the course of follow-up, 18% of patients had developed ACS or had died from other causes. Ultimately, after controlling for Framingham risk factors, the researchers found that having a CACS of at least 400 had been independently associated with a higher risk for ACS and mortality. Results were further adjusted for eGFR, proteinuria, hemoglobin, serum albumin, phosphate, low-density lipoprotein cholesterol, and C-reactive protein. However, these adjustments did not affect the association of CACS with ACS and death.
The researchers noted that having a CACS of at least 400 had demonstrated a specificity of 86% in predicting the future risk for ACS and mortality in patients with CKD.
“This study for the first time demonstrates the importance of subclinical coronary artery calcification in predicting future risk of ACS and mortality among asymptomatic non-dialysis CKD subjects,” the researchers concluded.
“These novel findings suggest that coronary artery calcification reflects atherosclerotic disease burden other than ‘mineral stress’ among CKD subjects. The potential value of CACS as a screening tool to early identify CKD subjects at future risk of ACS warrant further large scale evaluation.”
Reference:
Wang AYM, Wu HHL, Cheung SYL, Wong SSY, Yau YY, Ryskaliyeva S. Subclinical coronary artery calcification predicts future risk of acute coronary syndrome among non-dialysis CKD: a 5-year prospective analysis. Paper presented at: American Society of Nephrology Kidney Week 2017; October 31-November 5, 2017; New Orleans, LA. https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2788452.