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Impact of serum calcium and phosphate on coronary atherosclerosis detected by cardiac computed tomography.

 Sanghoon Shin  ;  Kwang-Joon Kim  ;  Hyuk-Jae Chang  ;  Iksung Cho  ;  Young Jin Kim  ;  Byoung-Wook Choi  ;  Yumie Rhee  ;  Sung-Kil Lim  ;  Woo-In Yang  ;  Chi-Young Shim  ;  Jong-Won Ha  ;  Yangsoo Jang  ;  Namsik Chung 
 European Heart Journal, Vol.33(22) : 2873-2881, 2012 
Journal Title
 European Heart Journal 
Issue Date
AIMS: High calcium (Ca), phosphate (P), and Ca-P product (CPP) are associated with cardiovascular disease in patients with chronic kidney disease. Whether this relationship persists in individuals with normal kidney function is not yet elucidated. We explored the relationship of serum Ca, P, and CPP to coronary atherosclerosis assessed by cardiac computed tomography angiography (cCTA) in participants with normal kidney function. METHODS AND RESULTS: This study included 7553 participants (52 ± 10 years, male 57%) with near-normal kidney function (estimated glomerular filtration rate > 60 mL/min/1.73 m2) who underwent cCTA. The relationship of Ca, P, and CPP to coronary atherosclerosis [coronary artery Ca score (CACS) >100 and the presence of coronary artery disease (CAD)] was evaluated. Higher Ca, P, and CPP were significantly associated with CACS > 100 continuously [adjusted odds ratio (OR) per mg/dL: Ca 1.21, P = 0.026; P 1.29, P < 0.001; CPP 1.03, P < 0.001]. However, they correlate only weakly with the presence of CAD (OR: Ca 1.17, P = 0.001; P 1.05, P = 0.173; CPP 1.01, P = 0.034). This discrepancy was because calcified or mixed plaque and non-calcified plaque (NCP) were included in CAD. A significant relationship was demonstrated between calcified or mixed plaque and Ca, P, and CPP (OR: Ca 1.20, P = 0.001; P 1.13, P = 0.003; CPP 1.02, P = 0.001), but not NCP. CONCLUSION: Elevated serum levels of Ca, P, and CPP are significantly associated with the presence of calcified coronary atherosclerotic plaque. It is unclear if there is a causal relationship. This relationship is thought to contribute to vascular calcification, but is less closely associated with NCP.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김광준(Kim, Kwang Joon) ORCID logo https://orcid.org/0000-0002-5554-8255
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
신상훈(Shin, Sang Hoon)
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
양우인(Yang, Woo In)
이유미(Rhee, Yumie) ORCID logo https://orcid.org/0000-0003-4227-5638
임승길(Lim, Sung Kil)
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
정남식(Chung, Nam Sik)
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
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