Impact of Hemodialysis Duration on Coronary Artery Calcification Among Hemodialysis Patients Who Underwent Percutaneous Coronary Intervention

Abstract

Our study aimed to evaluate the prevalence and impact of coronary artery calcification (CAC) on hemodialysis (HD) patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We enrolled 211 HD patients who underwent PCI (men: n = 155, age: 71 ± 1 0 years). Severe CAC was defined as calcification with an arc of 360° on intravascular ultrasound. Multivariate analysis was performed to determine the predictors of severe CAC. The impact of severe CAC on target lesion revascularization (TLR) was evaluated. Patients with severe CAC (46%) had a higher incidence of diabetes mellitus (DM) (79 vs 59%, P = .003) and longer HD duration (7.7 vs 3.4 years, P < .001) than those with non-severe CAC. Multivariate analysis demonstrated that DM, HD duration, and angiographic calcification were significant predictors for severe CAC (odds ratio 4.42, 1.13, and 6.62; P < .001, P < .001, and P < .001, respectively). After the median follow-up period of 580 days (interquartile range, 302–730 days), Kaplan–Meier curve analysis revealed that severe CAC was associated with an increased risk for TLR (χ2 12.7; P = .002). In HD patients with CAD after PCI, DM and HD duration were significant predictors for severe CAC. Furthermore, severe CAC was associated with an increased risk for TLR.

Impact of calcified nodule on target lesion failure after stent implantation in hemodialysis patients

“…A recent OCT study demonstrated that the calcium arc, calcium length, and calcium volume index were larger in CN lesions than in non‐CN lesions in patients with acute coronary syndrome 11 . Moreover, HD duration has been associated with severe calcium burden 22 . Accordingly, we believe that HD duration is important in predicting the presence of CN before PCI.…”

“…11 Moreover, HD duration has been associated with severe calcium burden. 22 Accordingly, we believe that HD duration is important in predicting the presence of CN before PCI. Our data also demonstrated that the lesion location differed between the CN and non-CN groups.…”