Aortic Valve Calcium Associates with All-Cause Mortality Independent of Coronary Artery Calcium and Inflammation in Patients with End-Stage Renal Disease

Lu Dai, Oscar Plunde, Abdul Rashid Qureshi, Bengt Lindholm, Torkel B. Brismar, Leon J. Schurgers, Magnus Soederberg, Jonaz Ripsweden, Magnus Back, Peter Stenvinkel*

*Corresponding author for this work

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Abstract

Background: Aortic valve calcium (AVC) and coronary artery calcium (CAC) are common complications in end-stage renal disease (ESRD). We investigated the prognostic significance of overlapping presence of AVC and CAC, and whether AVC was associated with all-cause mortality independent of the presence of CAC in ESRD. Methods: 259 ESRD patients (median age 55 years, 67% males) undergoing cardiac computed tomography were included. Framingham risk score (FRS), presence of cardiovascular disease (CVD), statin use, nutritional status and other relevant laboratory data were determined at baseline. During follow-up for median 36 months, 44 patients died, and 68 patients underwent renal transplantation. Results: The baseline overlap presence of AVC and CAC was 37%. Multivariate regression analysis showed that FRS (odds ratio (OR) 2.25; 95% confidence interval (95% CI), 1.43-3.55) and CAC score (OR (95% CI), 2.18 (1.34-3.59)) were independent determinants of AVC. In competing-risk regression models adjusted for presence of CAC, inflammation, nutritional status, CVD, FRS and statin use, AVC remained independently associated with all-cause mortality (sub-hazard ratio (95% CI), 2.57 (1.20-5.51)). Conclusions: The overlap of AVC and CAC was 37% in this ESRD cohort. AVC was associated with increased all-cause mortality independent of presence of CAC, traditional risk factors and inflammation.

Original languageEnglish
Article number607
Number of pages11
JournalJournal of Clinical Medicine
Volume9
Issue number2
DOIs
Publication statusPublished - Feb 2020

Keywords

  • aortic valve calcium
  • end-stage renal disease
  • coronary artery calcium
  • calcification
  • mortality
  • CHRONIC KIDNEY-DISEASE
  • C-REACTIVE PROTEIN
  • CARDIOVASCULAR MORTALITY
  • VALVULAR CALCIFICATION
  • HEMODIALYSIS-PATIENTS
  • ATHEROSCLEROSIS
  • RISK
  • MALNUTRITION
  • SCLEROSIS

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