Kim Hyunsuk, Lee Bom, Choi Gwangho, Jin Ho Yong, Jung Houn, Hwang Sunghyun, Yoon Hojung, Kim Seok Hyung, Park Hoon Suk, Lee Jongseok, Yoon Jong-Woo
Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea.
Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
J Clin Med. 2020 May 21;9(5):1558. doi: 10.3390/jcm9051558.
Vascular calcification is a major contributor to mortality in end-stage renal disease (ESRD) patients. In this study, we investigated whether there was a correlation between the coronary artery calcium score (CACS) and the vascular calcification score (VCS), and whether higher VCS increased the incidence of interventions and major adverse cardiac and cerebrovascular events (MACCE). ECG-gated CT, including vascular access and the coronary vessel, was taken. CACS and VCS were calculated by the Agatston method. A comparison of CACS and survival analysis according to VCS groups was performed. Using a cutoff of VCS = 500, 77 patients were divided into two groups. The vintage was significantly older in the higher VCS group. The median CACS was higher in the higher VCS group (21 [0, 171] vs. 552 [93, 2430], < 0.001). The hazard ratio (HR) for interventions and MACCEs in the higher VCS group increased by 3.2 and 2.3, respectively. Additionally, a longer duration of hemodialysis and higher magnesium levels (>2.5 mg/dL) showed lower HRs for interventions (<1). We quantified VCS and found that it was associated with the CACS. Additionally, higher VCS increased the risk of access interventions and MACCE. VCS of the access site may be suggested as a biomarker to predict ESRD patients.
血管钙化是终末期肾病（ESRD）患者死亡的主要原因。在本研究中，我们调查了冠状动脉钙化评分（CACS）与血管钙化评分（VCS）之间是否存在相关性，以及较高的VCS是否会增加干预措施的发生率以及主要不良心脑血管事件（MACCE）。进行了包括血管通路和冠状动脉的心电图门控CT检查。CACS和VCS采用阿加斯顿方法计算。根据VCS组对CACS进行比较并进行生存分析。以VCS = 500为临界值，将77例患者分为两组。较高VCS组的患者年龄明显更大。较高VCS组的CACS中位数更高（21 [0, 171] 对比 552 [93, 2430]，<0.001）。较高VCS组干预措施和MACCE的风险比（HR）分别增加了3.2和2.3。此外，较长的血液透析时间和较高的镁水平（>2.5 mg/dL）显示干预措施的HR较低（<1）。我们对VCS进行了量化，发现它与CACS相关。此外，较高的VCS增加了血管通路干预和MACCE的风险。血管通路部位的VCS可能被建议作为预测ESRD患者的生物标志物。
