Key result
Moderate-to-severe aortic arch calcification linked to ~272% higher MACE risk in ESKD patients.
Why the study?
Factors influencing cardiovascular risk associated with vascular calcification in chronic kidney disease are less well addressed, and whether echocardiographic LVH affects this risk in ESKD patients is unknown.
Does echocardiographic left ventricular hypertrophy modify the risk of major adverse cardiac events associated with aortic arch calcification in end-stage kidney disease patients?
Cohort (n=283)
Does echocardiographic left ventricular hypertrophy modify the risk of major adverse cardiac events associated with aortic arch calcification in end-stage kidney disease patients?
Effect estimate: HR 3.72 (95% CI 1.58-8.73)
Absolute Event Rate: 50% vs 13.6%
In patients with end-stage kidney disease, the presence of echocardiographic left ventricular hypertrophy exacerbates the risk of major adverse cardiac events associated with aortic arch calcification.
Background: The factors affecting cardiovascular risk associated with vascular calcification in patients with chronic kidney disease are less well addressed. Distinct risk factors may contribute synergistically to this elevated cardiovascular risk in this population. Objectives: We aimed to determine whether echocardiographic left ventricular hypertrophy (LVH) affects the risk of major adverse cardiac events (MACE) associated with vascular calcification in end-stage kidney disease (ESKD) patients. Methods: In this retrospective cohort study, ESKD patients underwent chest radiography and echocardiography to assess aortic arch calcification (AoAC) and LVH, respectively, and were classified into three groups accordingly: non-to-mild AoAC without LVH, non-to-mild AoAC with LVH, and moderate-to-severe AoAC. The risks of MACE, cardiovascular mortality, and overall mortality were assessed using Cox proportional hazard analysis. Results: Of the 283 enrolled ESKD patients, 44 (15.5%) had non-to-mild AoAC without LVH, 117 (41.3%) had non-to-mild AoAC with LVH, and 122 (43.1%) had moderate-to-severe AoAC. After 34.1 months, 107 (37.8%) participants developed MACE, including 6 (13.6%), 40 (34.2%), and 61 (50%) from each respective group. Those with moderate-to-severe AoAC (Hazard ratio, 3.72; 95% confidence interval, 1.58–8.73) had a significantly higher risk of MACE than did those with non-to-mild AoAC without LVH or with non-to-mild AoAC and LVH (Hazard ratio, 2.73; 95% confidence interval, 1.16–6.46). A similar trend was observed for cardiovascular and overall mortality. Conclusion: Echocardiographic LVH could modify the risk of adverse cardiovascular events associated with vascular calcification in ESKD patients. Interventions aiming to ameliorate both morbidities might be translated into a lower MACE risk in this population.
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Chao et al. (2024) conducted a cohort in End-stage kidney disease (n=283). Moderate-to-severe aortic arch calcification vs. Non-to-mild aortic arch calcification without LVH was evaluated on Major adverse cardiac events (MACE) (HR 3.72, 95% CI 1.58-8.73). Moderate-to-severe aortic arch calcification significantly increased the risk of MACE compared to non-to-mild calcification without LVH (HR 3.72; 95% CI 1.58-8.73) in ESKD patients.
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