Document Detail


Progression of coronary artery calcification and thoracic aorta calcification in kidney transplant recipients.
MedLine Citation:
PMID:  21944666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Vascular calcification independently predicts cardiovascular disease, the major cause of death in kidney transplant recipients (KTRs). Longitudinal studies of vascular calcification in KTRs are few and small and have short follow-up. We assessed the evolution of coronary artery (CAC) and thoracic aorta calcification and their determinants in a cohort of prevalent KTRs.
STUDY DESIGN: Longitudinal.
SETTING & PARTICIPANTS: The Agatston score of coronary arteries and thoracic aorta was measured by 16-slice spiral computed tomography in 281 KTRs.
PREDICTORS: Demographic, clinical, and biochemical parameters were recorded simultaneously.
OUTCOMES & MEASUREMENTS: The Agatston score was measured again 3.5 or more years later.
RESULTS: Repeated analyzable computed tomographic scans were available for 197 (70%) KTRs after 4.40 ± 0.28 years; they were not available for the rest of patients because of death (n = 40), atrial fibrillation (n = 1), other arrhythmias (n = 4), refusal (n = 35), or technical problems precluding confident calcium scoring (n = 4). CAC and aorta calcification scores increased significantly (by a median of 11% and 4% per year, respectively) during follow-up. By multivariable linear regression, higher baseline CAC score, history of cardiovascular event, use of a statin, and lower 25-hydroxyvitamin D(3) level were independent determinants of CAC progression. Independent determinants of aorta calcification progression were higher baseline aorta calcification score, higher pulse pressure, use of a statin, older age, higher serum phosphate level, use of aspirin, and male sex. Significant regression of CAC or aorta calcification was not observed in this cohort.
LIMITATIONS: Cohort of prevalent KTRs with potential survival bias; few patients with diabetes and nonwhites, limiting the generalizability of results.
CONCLUSION: In contrast to previous small short-term studies, we show that vascular calcification progression is substantial within 4 years in prevalent KTRs and is associated with several traditional and nontraditional cardiovascular risk factors, some of which are modifiable.
Authors:
Céline Maréchal; Emmanuel Coche; Eric Goffin; Anca Dragean; Georg Schlieper; Pauline Nguyen; Jürgen Floege; Nada Kanaan; Olivier Devuyst; Michel Jadoul
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-09-23
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  59     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-16     Completed Date:  2012-03-22     Revised Date:  2013-10-09    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  258-69     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Nephrology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain Medical School, Brussels, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aorta, Thoracic / pathology*,  radiography
Aortic Diseases / complications,  pathology*,  radiography
Calcinosis / complications,  pathology*,  radiography
Cardiovascular Diseases / epidemiology
Coronary Angiography
Coronary Artery Disease / complications,  pathology*,  radiography
Coronary Vessels / pathology*
Disease Progression*
Female
Follow-Up Studies
Humans
Kidney Transplantation / mortality,  pathology*,  radiography
Linear Models
Longitudinal Studies
Male
Middle Aged
Risk Factors
Survival Rate
Tomography, Spiral Computed
Comments/Corrections
Comment In:
Am J Kidney Dis. 2013 Sep;62(3):644-5   [PMID:  23972064 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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