Suh Sang Heon, Oh Tae Ryom, Choi Hong Sang, Kim Chang Seong, Bae Eun Hui, Oh Kook-Hwan, Lee Joongyub, Oh Yun Kyu, Jung Ji Yong, Ma Seong Kwon, Kim Soo Wan
Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju 61469, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea.
J Clin Med. 2022 Feb 22;11(5):1157. doi: 10.3390/jcm11051157.
To investigate the association between abdominal aortic calcification score (AACS) assessed by plain radiograph of the lateral abdomen and the risk of cardiovascular (CV) events in patients with pre-dialysis chronic kidney disease (CKD), a total of 2090 pre-dialysis CKD patients from the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) were categorized by AACS into 0, 1-2, 3-4, 5-6, and ≥7. The primary outcome of the study was the composite CV events, defined as a composite of non-fatal CV events and all-cause death. The risk of composite CV events was significantly higher in the subjects with AACS ≥ 7 (adjusted hazard ratio (HR) 1.888, 95% confidence interval (CI) 1.219 to 2.923), compared to that of the subjects with AACS 0. The risks of fatal and non-fatal CV events (adjusted HR 1.052, 95% CI 1.030 to 1.073) and all-cause death (adjusted HR 1.949, 95% CI 1.073 to 3.539) were also significantly higher in the subjects with AACS ≥ 7. In conclusion, AACS assessed by plain radiograph is independently associated with adverse CV outcomes in patients with pre-dialysis CKD. A simple radiographic examination of the lateral abdomen may help CV risk stratification in this population.
为了研究通过腹部侧位平片评估的腹主动脉钙化评分（AACS）与透析前慢性肾脏病（CKD）患者心血管（CV）事件风险之间的关联，来自韩国慢性肾脏病患者结局队列研究（KNOW-CKD）的2090例透析前CKD患者根据AACS分为0、1 - 2、3 - 4、5 - 6和≥7组。该研究的主要结局是复合CV事件，定义为非致命性CV事件和全因死亡的复合事件。与AACS为0的受试者相比，AACS≥7的受试者发生复合CV事件的风险显著更高（校正风险比（HR）1.888，95%置信区间（CI）1.219至2.923）。AACS≥7的受试者发生致命性和非致命性CV事件（校正HR 1.052，95%CI 1.030至1.073）以及全因死亡（校正HR 1.949，95%CI 1.073至3.539）的风险也显著更高。总之，通过平片评估的AACS与透析前CKD患者的不良CV结局独立相关。对腹部侧位进行简单的影像学检查可能有助于该人群的CV风险分层。
