Unit of Nephrology, Dialysis and transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Sci Rep. 2019 May 3;9(1):6869. doi: 10.1038/s41598-019-43216-4.
Coronary artery calcifications(CACs), are related to the increased cardiovascular mortality during kidney transplantation(KTx). Using coronary-CT performed at 1 month(T0) and 5 years(T5) after KTx we evaluated: (1) the prevalence of CACs; (2) the clinical and biochemical factors related to CACs; 3) the factors implicated with CACs progression. We evaluated 67-pts selected from the 103-pts transplanted in our unit between 2007 and 2008. Clinical and biochemical parameters were recorded at the time of pre-KTx evaluation and for five years after KTx. Coronary-CT for the Agatson score (AS) evaluation was performed at T0 and at T5, and CACs progression was determined. At baseline AS was 45 [0-233]. At T5 AS was 119 [1-413]. At T0, 69% of patients had CACs. Age and dialytic vintage were the main independent variables related to CACs. At T5, CACs were present in 76% of patients. Age was the only independent factor in determining CACs. A progression of CACs was observed in 74% of patients. They were older, had higher CACs-T0 and higher SBP throughout the 5-years. The presence of CACs at T0 and age were the only independent factors in determining the CACs-progression. CACs-T0 had the best discriminative power for CACs progression. CACs prevalence is quite high in KTx patients; Age is strictly related to CACs; Age and the presence of CACs at baseline were the two major factors associated with the progression of CACs during the five years of follow up. CACs-T0 had the best discriminative power for progression of CACs.
冠状动脉钙化（CACs）与肾移植（KTx）后心血管死亡率增加有关。我们使用 KTx 后 1 个月（T0）和 5 年后（T5）进行的冠状动脉 CT 评估了：（1）CACs 的患病率；（2）与 CACs 相关的临床和生化因素；（3）与 CACs 进展相关的因素。我们从 2007 年至 2008 年在我们科室接受移植的 103 例患者中选择了 67 例患者进行评估。在接受 KTx 前评估和 KTx 后 5 年内记录了临床和生化参数。在 T0 和 T5 时进行冠状动脉 CT 以评估 Agatson 评分（AS），并确定 CACs 的进展情况。基线时 AS 为 45[0-233]。在 T5 时，AS 为 119[1-413]。在 T0，69%的患者存在 CACs。年龄和透析龄是与 CACs 相关的主要独立变量。在 T5，76%的患者存在 CACs。年龄是确定 CACs 的唯一独立因素。74%的患者观察到 CACs 进展。他们年龄更大，CACs-T0 更高，整个 5 年期间 SBP 更高。T0 时 CACs 的存在和年龄是确定 CACs 进展的唯一独立因素。CACs-T0 对 CACs 进展具有最佳的判别能力。CACs 在 KTx 患者中患病率相当高；年龄与 CACs 密切相关；年龄和基线时 CACs 的存在是与 5 年随访期间 CACs 进展相关的两个主要因素。CACs-T0 对 CACs 进展具有最佳的判别能力。
