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ISSN 1995-9427 (Print)

2015, Number 2

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Invest Medicoquir 2015; 7 (2)

Cardiovascular risk according to coronary calcium score in chronic renal insufficient patients without known cardiovascular

Ugarte MD, Ugarte SJC, Fernández BJE, Miñoso AY, Díaz RB

Language: Spanish
References: 35
Page: 237-252
PDF size: 291.72 Kb.


ABSTRACT

Introduction: Chronic renal failure is defined as a kidney structural and/or functional damage for more than three months’ development and multiple etiologies. In the cardiovascular system lie the main causes of morbidity and mortality of patients with chronic renal failure in any of its stages. The purpose of this study was to determine the cardiovascular risk according to the coronary calcium score in patients with chronic renal failure but without known cardiovascular disease. Methods: An observational descriptive study was conducted at the Medical Surgical Research Center, with a sample of 20 patients diagnosed with chronic renal failure for the study and 20 healthy patients in the control group, calculating the calcium score in the coronary arteries by computed tomography and using the method of Agatston. Results: Age was positively correlated with the levels of coronary calcium, while the glomerular filtration rate and stage of CKD showed no significant association. Patients with chronic renal failure had higher values of total and artery calcium than those without the disease. Conclusions: Cardiovascular risk, according to the coronary calcium score, was significantly higher in chronic renal failure patients, surpassing the UA 400 in all cases; so these patients have a high probability of developing a cardiovascular event in the next two years.


REFERENCES

  1. Barreto DV, Barreto C, Carvalho AB, Cuppari L, Draibe SA, Dalboni MA, et al. Association of changes in bone remodeling and coronary calcification in hemodialysis patients: a prospective study. Am J Kidney Dis. 2008;52(6):1139-50.

  2. Dellegrottaglie S, Saran R, Gillespie B, Zhang X, Chung S, Finkelstein F, et al. Prevalence and predictors of cardiovascular calcium in chronic kidney disease (from the Prospective Longitudinal RRI-CKD Study). Am J Cardiol.2006;98(5):571-6.

  3. Jean G, Bresson E, Terrat JC, Vanel T, Hurot JM, Lorriaux C, et al. Peripheral vascular calcification in long-haemodialysis patients: associated factors and survival consequences. Nephrol Dial Transplant. 2009;24(3):948-55.

  4. Kwon SW, Kim YJ, Shim J, Sung JM, Han ME, Kang DW, et al. Coronary artery calcium scoring does not add prognostic value to standard 64-section CT angiography protocol in low-risk patients suspected of having coronary artery disease. Radiol. 2011;259(1):92-9.

  5. Kurt SM, Lee AL, Winters TJ, Tam E, Jaleel M, Stenvinkel P, et al. Low serum uric acid level is a risk factor for death in incident hemodialysis patients. Am J Nephrol. 2009(2);29:79-85.

  6. Gowdak LH, de Paula FJ, Cesar LA, Martínez EE, Lanhez LE, Krieger EM, et al. Screening for significant coronary artery disease in high-risk renal transplant candidates. Coron Artery Dis. 2007;18(7):553-8.

  7. Masho Y, Shigematsu T. Arteriosclerosis and vascular calcification in chronic kidney disease (CKD) patients. Clin Calcium. 2007;17(3):354-8.

  8. Rashid G, Plotkin L, Klein O, Green J, Bernheim J, Benchetrit S. Parathyroid hormone decreases endothelial osteoprotegerin secretion: role of protein kinase A and C. Am J Physiol. 2009;296(1):60-6.

  9. Latif W, Karaboyas A, Tong L, Winchester JF. Uric acid level and all-cause and cardiovascular mortality in the hemodialisis population.Clin J Am SocNephrol. 2011;6(10):2470-7.

  10. FernándezL, GarcíaA, BagheriannejadF, Malick W, Mirelis JG, Sawit ST, et al. Diagnostic value of coronary artery calcium scoring in low-intermediate risk patients evaluated in the emergency department for acute coronary syndrome. Am J. Cardiol. 2011;107(1):17-23.

  11. Arbab-Zadeh A, Miller JM, Rochitte CE, Dewey M, Niinuma H, Gottlieb I, et al. Diagnostic accuracy of computed tomography coronary angiography according to pre-test probability of coronary artery disease and severity of coronary arterial calcification. The CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) InternationalMulticenter Study. J Am CollCardiol. 2012;59(4):379-87.

  12. Church TS, Levine BD, McGuire DK, Lamonte MJ, Fitzgerald SJ, Cheng YJ, et al. Coronary artery calcium score, risk factors, and incident coronary heart disease events. Atheroscleros. 2007;190(1):224-31.

  13. Descalzo M, Leta R, Rosselló X, Alomar X, Carreras F, Pons-Lladó G. Enfermedad coronaria subclínica por tomografía computarizada multidetector en población asintomática estratificada por nivel de riesgo coronario. Rev Esp Cardiol. 2013;66(8):504-5.

  14. Degano IR, Elosúa R, Marrugat J. Epidemiología del síndrome coronario agudo en España: estimación del número de casos y la tendencia de 2005 a 2049. RevEspCardiol.2013;66(6):472-81.

  15. Degano IR, Elosua R, Kaski JC, Fernández-Bergés DJ, Grau M, Marrugat J. Estabilidad de la placa aterosclerótica y la paradoja del sur de Europa. RevEspCardiol.2013;66(1):56-62.

  16. He ZX, Hedrick TD, Pratt CM, Verani MS, Aquino V, Roberts R, et al. Severity of coronary artery calcification by electron beam computed tomography predicts silent myocardial ischemia. Circulation. 2000;101(3):244-51.

  17. Fernández J, López E. Carga económica y social de la enfermedad coronaria. Rev Esp Cardiol Supl. 2013:13(Supl B):S42-7.

  18. Greenland P, Bonow RO, Brundage BH, Budoff MJ, Eisenberg MJ, Grundy SM, et al. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain. J Am CollCardiol. 2007;49(3):378-402.

  19. Hadamitzky M, Distler R, Meyer T, Hein F, Kastrati A, Martinoffs, et al. Prognostic value of coronary computed tomographic angiography in comparison with calcium scoring and clinical risk scores. Circ Cardiovasc Imaging. 2011;4(1):16-23.

  20. Drueke T, Salusky I. Soft tissue calcification in chronic renal failure. In the spectrum of renal osteodystrophy.Oxford Edited By; 2000. p. 346-67.

  21. Wallin R, Wajih N, Greenwood T, Sane DC. Arterial calcification: A review of mechanisms, animals’ models and the prospects of therapy. Med Res Rev. 2001;21(4):274-301.

  22. Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, et al. Coronary artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med. 2000;342(20):1478-83.

  23. London GM, Guerin AP, Marchais SJ, Métivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant. 2003;18(9):1731-40.

  24. Safar ME, Blacher J, Pannier B, Guerain AP, Marchais SJ, Guyonvarch PM, et al. Central pulse pressure and mortality in end-stage renal disease. Hypertens. 2002;39(3):735-8.

  25. London GM. Cardiovascular calcifications in uremic patients: clinical impact on cardiovascular function. J Am Soc Nephrol. 2003;14(Suppl 4):S305-S9.

  26. Raggi P, Boulay A, Chasan S, Amin N, Dillon M, Burke SK, et al. Cardiac calcification in adult hemodialysis patients: A link between end-stage renal disease and cardiovascular disease. J Am Coll Cardiol. 2002;39(4):695-701.

  27. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Petrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am CollCardiol. 1999;15(4):827-32.

  28. Ugarte JC. Manual de Tomografía Axial Computarizada Multicorte. 3era ed. La Habana. Editorial Federico Engels; 2006.

  29. Raggi P, Callister TQ, Coolí B, He ZX, Lippolis NJ, Russo DJ, et al. Identification of patients at increased risk of first unheralded acute myocardial infarction by electron bean computed tomography. Circulation. 2000;101(8):850-5.

  30. CallisterTQ, Coolí B, Raya SP, Lippolis NJ, Russo DJ, Raggi P. Coronary artery disease. Improved reproductibility of calcium scoring with an electron beam CT volumetric method.Radiology.1998;208(3):807-14.

  31. Kuettner A, Trabold T, Schroeder S, Feyer A, Beck T, Brueckner A, et al Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: initial clinical results. J Am Coll Cardiol. 2004;44(6):1230-7.

  32. Hounsfield GN. Computed Medical imaging: Nobel lecture, Dec 8, 1979; Comp Assist Tomograp.1980;4(5):665-74.

  33. Betriu A, Fernández E. La ecografía carotídea en el diagnóstico precoz de enfermedad arterial ateromatosa en la enfermedad renal crónica. Nefrolog Madrid. 2012;32(1):4-6.

  34. Carda R, De Agustína J, Manzanoa MC, García JC, Fernández A, Isidre VilacostaI, Macaya C. Valor pronóstico intrahospitalario del filtrado glomerular en pacientes con síndrome coronario agudo y creatinina normal. RevEspCardiol. 2007;60:714-60. 35. Descalzo M, Vidal R, Leta R, Alomar X, Pons G, Carreras F. Usefulness of coronary artery calcium for detecting significant coronary artery disease in asymptomatic individuals. RevClínEsp. 2014;214(5):235-41. 36. Vinyoles E. Eventos cardiovasculares en hipertensos de riesgo elevado en función del filtrado glomerular. Datos del estudio ALLHAT. Rev Hipertens Riesg Vasc. 2006;23(2):68-72.

  35. Abraão M, de Lima JJ, Parga JR, Ávila LF, Gowdak LH, Lemos PA, et al. Score de calcio coronario predice estenosis y eventos en la insuficiencia renal crónica pre trasplante. Arq Bras Cardiol. 2010;94(2):5




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