Vascular Calcification on Plain Radiographs Is Related with the Severity of Lesions Detected by Coronary Angiography in Dialysis Patients

Abstract

Coronary artery disease (CAD) is a primary cause of mortality and morbidity in dialysis patients. However, it is difficult to select the proper point for coronary angiographic procedure, because dialysis patients frequently do not display typical symptoms. Vascular calcification (VC) scores of artery or aorta on plain radiographs are associated with CAD events and may be predictive of CAD in dialysis patients. Therefore, we evaluated whether high or meaningful VC scores on plain radiographs are related with the severity of lesions detected by coronary angiography (CAG) in dialysis patients. We retrospectively enrolled dialysis patients who underwent CAG and checked several plain radiographs within one year before or after CAG. Significant VC is defined as high or meaningful VC scores, such as long abdominal aortic calcification and medial artery calcification on feet. Of all 55 patients, 41 patients (74.5%) exhibited significant VC on plain radiographs and 23 patients (41.8%) underwent stent insertion. Among the 23 patients, longer stents were used in 18 patients with significant VC (34.1 ± 19.5 mm vs. 16.6 ± 15.2 mm, P = 0.029). Patients with significant VC showed higher prevalence rate of severe coronary artery calcification (P = 0.007) and diffuse/tubular stenosis (P = 0.012), detected by CAG, than those without significant VC. Thus, high or meaningful VC scores on plain radiographs were associated with the degree of calcification or stenosis detected by CAG. In conclusion, VC scores on plain radiographs may be predictive of calcification or stenosis of coronary artery before CAG in dialysis patients.

Serum myostatin levels are associated with abdominal aortic calcification in dialysis patients

“…VC, a phenotype of vascular aging, is common in dialysis patients with longer dialysis histories and increases the risk of morbidity and mortality in these patients. Previous studies have shown that the abdominal aortic calcification (AAC) score on plain radiography has a very good correlation with the identification of coronary artery calcification and low bone mass, which are risk factors for mortality [8,9]. A previous human study reported that serum myostatin levels were negatively associated with AAC in older males [10].…”

Abdominal aortic calcification score among several vascular calcification scores of plain radiograph is the most reliable predictor of severe coronary artery calcification in dialysis patients

“…Previous studies have reported that VC scores on plain radiographs are associated with cardiac events in dialysis patients [3–7]. It has also been illustrated that high or meaningful VC scores on plain radiographs may act as a predictor of cardiac calcification or stenosis before coronary angiography in dialysis patients [8]. One previous study showed that the abdominal aortic calcification (AAC) score on plain radiographs had a very good correlation with the identification of CAC on CT [9].…”

Both pelvic radiography and lateral abdominal radiography correlate well with coronary artery calcification measured by computed tomography in hemodialysis patients: A cross‐sectional study

“…Studies have identified that plain radiographs may also be used to indicate coronary artery calcification . Abdominal aortic calcification was also reported to be associated with coronary artery calcification determined by coronary angiography . KDIGO suggested lateral abdominal radiography as an alternative to CT .…”