Key result
Every 20-unit increase in coronary artery calcification score was associated with a 23% increased risk of a 1-m/s increase in PWV and a 32% increased risk of a 1 ms increase in QTd.
Why the study?
The mechanisms by which vascular calcification predisposes to cardiovascular mortality in maintenance dialysis patients remain unclear.
Does coronary artery calcification progression associate with worsening arterial stiffness and cardiac repolarization in hemodialysis patients?
Cohort (n=132)
Does coronary artery calcification progression associate with worsening arterial stiffness and cardiac repolarization in hemodialysis patients?
In patients new to hemodialysis, progression of coronary artery calcification is significantly associated with worsening arterial stiffness and cardiac repolarization abnormalities.
Answers are grounded in this paper and cite their sources.
CAC progression was associated with worsening arterial stiffness and repolarization in new hemodialysis patients; hypothesis-generating and requires prospective validation.
BACKGROUND/AIMS: Evidence suggests that vascular calcification (VC) portends poor cardiovascular (CV) prognosis in patients undergoing maintenance dialysis (CKD-5). Nonetheless, how VC might predispose to CV mortality still remains to be clarified. Herein, we report on the association between coronary artery calcification (CAC) progression and changes in cardiac repolarization as well as arterial stiffness. METHODS: 132 patients new to dialysis were identified. Demographic and clinical characteristics were collected at study entry and during the 12-month follow-up. CAC, 12-lead ECG and pulse wave velocity (PWV) were assessed at baseline and study completion. Uni- and multivariable analyses were applied to detect factors associated with worsening of cardiac repolarization (QTd) and arterial stiffness (PWV). RESULTS: Uni- and multivariable analyses revealed that CAC progression was associated with a significant increase in both QTd and PWV. Every 20-unit increase in the CAC score corresponded to a significant 23% (95% CI 1.12-1.27; p < 0.001) and 32% (95% CI 1.09-1.37; p < 0.01) increase in the risk of experiencing a 1-m/s increase in PWV and 1 ms in QTd, respectively. CONCLUSION: VC is a marker of vasculopathy and appears to be associated with cardiac repolarization and arterial stiffness abnormalities in CKD-5 patients.
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Iorio et al. (2011) conducted a cohort in Hemodialysis (CKD-5) (n=132). Coronary artery calcification (CAC) progression was evaluated on 1-m/s increase in pulse wave velocity (PWV) per 20-unit increase in CAC score (23% increase in risk, 95% CI 1.12-1.27, p=<0.001). Every 20-unit increase in coronary artery calcification score was associated with a 23% increased risk of a 1-m/s increase in PWV and a 32% increased risk of a 1 ms increase in QTd.
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