Progression of coronary artery calcification using a multidetector CT on hemodialysis patients in one year

Abstract

BACKGROUND: Vascular calcification is increasingly appreciated as an important risk factor for cardiovascular morbidity and mortality. AIMS: To assess (1) the evolution of coronary calcification and (2) the relationship of the progression of coronary calcification with risk factors and adverse cardiovascular events. METHODS: We performed repeated 16 row multidetector computed tomography (CT) with an interval of 1 year on 33 patients on chronic hemodialysis. RESULTS: Progression of coronary artery calcification was found in 70% of patients with a mean significant difference of calcium score. Patients older than 65 years demonstrated a higher progression of coronary calcification and patients who received non-calcium phosphate binder treatments demonstrated less progression. During the year, 6 adverse cardiovascular events occurred. A total of 22% of patients with progression of coronary calcification had a cardiovascular event (p=.003). Factors associated with adverse cardiovascular events included diabetes, male gender, history of cerebrovascular and coronary disease, secondary hyperparathyroidism, hyperphosphatemia, and calcification of circumflex and right coronary arteries. CONCLUSIONS: Coronary artery calcification progression is common, represents a risk factor to adverse cardiovascular events, and is associated with modifiable risk factors in chronic hemodialysis. Multidetector CT seems to be an effective and readily applicable method to assess and quantify the progression of coronary artery calcification.