Here is a study showing that Coronary Artery calcification predicted the cerebrovascular events in those without its history in Chronic Kidney Disease patients irrespective of presence or absence of diabetes.

Team@CMHF

In a multivariable analysis, a coronary artery calcification (CAC) score >100 tripled the risk of myocardial infarction (MI), and any accumulation of coronary calcification tripled the risk of CVD.

An analysis that compared patients with and without CVD showed that increasing amounts of CAC predicted an increased risk of CVD events in patients with CKD, but no history of cardiovascular events.

In contrast, rising CAC scores did not predict CVD events in CKD patients with established CVD, as reported at the American Society of Nephrology meeting. A similar pattern of association was observed in patients with, and without, diabetes in those with more severe CKD.

“Our study indicates that CAC predicts the increased risk of development of MI and CVD events beyond traditional risk factors among patients with CKD,” said Jing Chen, MD, of Tulane University in New Orleans.

As part of the CRIC study design, 1,902 participants had baseline assessments of CAC by electron-beam CT (EBCT). Follow up in the subgroup continued for a median of 2.1 years.
Investigators examined the association between CAC and various clinical events and overall mortality, grouping patients by Agatston score:

• 0=none
• >0 to ≤100=moderate calcification
• >100=increased calcification

Multivariate analysis revealed two significant associations: an Agatston score >100 was associated with an MI hazard ratio of 3.14 (P=0.018), as compared with less amounts of calcification. A score >100 was associated with a hazard ratio of 3.02 for CVD events, and a score of >0 to <100 was associated with a hazard ratio of 2.79 (P=0.014).

CAC did not predict the risk of CVD events in patients with CVD at baseline,
Among patients with no history of CVD, the event rate increased from 0.7% per year in association with an Agatston score of 0 to 2.46% for a score >0 to <100 and 3.84% for a score >100 (P<0.0001 for trend).

CAC predicted the risk of CVD event in patients with and without diabetes.

Examination of CAC score and estimated glomerular filtration rate (eGFR) showed that CAC predicted the risk of CVD events across the spectrum of eGFR values.

In patients with an eGFR <45 mL/min, the annual event rate increased from 1.96% to 6.52% as the CAC score increased (P=0.0003).

In the subgroup with an eGFR ≥45 mL/min, the annual CVD event rate increased with CAC score from 0.29% to 2.94% (P=0.009).

A multivariate analysis of the risk of CVD events by CAC score showed that a score of >0 to <100 or a score >100, as compared with 0, was associated with a significantly increased hazard ratio in patients with:

• No history of CVD
• No history of diabetes
• An eGFR ≥45 mL/min

Ref: http://www.medpagetoday.com/MeetingCoverage/ASN/29722?utm_source=WC&utm_medium=email&utm_campaign=Meeting_Roundup_ASN