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Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy

Authors
 Jung Eun Lee  ;  Yong Kyu Lee  ;  Eun Jeong Choi  ;  Ji Sun Nam  ;  Byoung Wook Choi  ;  Beom Seok Kim 
Citation
 SCIENTIFIC WORLD JOURNAL, Vol.2013 : 916354, 2013 
Journal Title
 SCIENTIFIC WORLD JOURNAL 
ISSN
 2356-6140 
Issue Date
2013
MeSH
Adult ; Aged ; Coronary Stenosis/complications ; Coronary Stenosis/diagnostic imaging* ; Female ; Humans ; Kidney Failure, Chronic/complications* ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Renal Replacement Therapy* ; Tomography, X-Ray Computed/methods*
Keywords
Adult ; Aged ; Coronary Stenosis/complications ; Coronary Stenosis/diagnostic imaging* ; Female ; Humans ; Kidney Failure, Chronic/complications* ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Renal Replacement Therapy* ; Tomography, X-Ray Computed/methods*
Abstract
Background. The prevalence of coronary artery stenosis (CAS) at the initiation of renal replacement therapy (RRT) in chronic kidney disease (CKD) patients has not been fully elucidated. Although coronary angiography is the gold standard in diagnosing CAS its invasiveness and economic burden lead to searching for a noninvasive alternative method. In this study, we evaluated the prevalence of CAS by multidetector row computed tomography (MDCT) and related risk factor to articulate the usefulness of MDCT. Method. Seventy-four asymptomatic CKD patients who began dialysis were evaluated with echocardiography and MDCT. The patients were stratified into two groups according to CAS and coronary artery calcification score (CACS) by MDCT to detect silent CAS and evaluate its predictability for cardiac events. Results. CAS was seen in 24 (32.4%) of 74 asymptomatic CKD patients on MDCT. Both groups showed increasing frequencies of CAS with age (P < 0.01), presence of diabetes (P < 0.05), uric acid level (P < 0.01), and calcium score (P < 0.01). Multiple regression analysis revealed that age and uric acid level were independent risk factors for CAS and high CACS in asymptomatic CKD patients at the initiation of dialysis. Patients with both CAS and high CACS were presented with higher cardiac events rates compared to those without any of them. In Cox regression model, age and the presence of CAS and high CACS on MDCT were an independent risk factor for cardiac events in these patients. Conclusion. We showed that CAS was highly seen in asymptomatic CKD patients starting dialysis. Moreover, both high CACS and CAS on MDCT might predict cardiac events in these patients and MDCT can be a useful screening tool for evaluating coronary artery disease and predicting cardiovascular mortality noninvasively.
Files in This Item:
T201305540.pdf Download
DOI
10.1155/2013/916354
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Nam, Ji Sun(남지선) ORCID logo https://orcid.org/0000-0001-8655-5258
Lee, Jung Eun(이정은) ORCID logo https://orcid.org/0000-0003-0917-2872
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89052
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