Coronary and extra-coronary artery calcium scores as predictors of cardiovascular events and mortality in chronic kidney disease stages 1–5: a prospective cohort study

ABSTRACT Background Vascular calcification is a known risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, since there is a lack of studies examining several arterial regions at a time, we aimed to evaluate the risk of major adverse cardiovascul...

Full description

Saved in:
Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2023-05, Vol.38 (5), p.1227-1239
Main Authors: Sørensen, Ida M H, Bjergfelt, Sasha S, Hjortkjær, Henrik Ø, Kofoed, Klaus F, Lange, Theis, Feldt-Rasmussen, Bo, Christoffersen, Christina, Bro, Susanne
Format: Article
Language:English
Subjects:
Calcium
Cardiovascular Diseases - complications
Cardiovascular Diseases - etiology
Coronary Artery Disease - complications
Coronary Artery Disease - etiology
Coronary Vessels
Humans
Prospective Studies
Renal Insufficiency, Chronic - therapy
Risk Factors
Vascular Calcification - diagnostic imaging
Vascular Calcification - etiology
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites cdi_FETCH-LOGICAL-c278t-75094161a3f77697fbf7f25ff37fe1ad72abef3374204337acbd0728b0ce66d03
container_end_page 1239
container_issue 5
container_start_page 1227
container_title Nephrology, dialysis, transplantation
container_volume 38
creator Sørensen, Ida M H
Bjergfelt, Sasha S
Hjortkjær, Henrik Ø
Kofoed, Klaus F
Lange, Theis
Feldt-Rasmussen, Bo
Christoffersen, Christina
Bro, Susanne
description ABSTRACT Background Vascular calcification is a known risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, since there is a lack of studies examining several arterial regions at a time, we aimed to evaluate the risk of major adverse cardiovascular events (MACE) and all-cause mortality according to calcium scores in five major arterial sites. Methods This was a prospective study of 580 patients from the Copenhagen CKD Cohort. Multidetector computed tomography of the coronary and carotid arteries, the thoracic aorta, the abdominal aorta and the iliac arteries was used to determine vascular calcification at baseline. Calcium scores were divided into categories: 0, 1–100, 101–400 and >400. Results During the follow-up period of 4.1 years a total of 59 cardiovascular events and 64 all-cause deaths occurred. In Cox proportional hazards models adjusted for age, sex, estimated glomerular filtration rate, hypertension, diabetes mellitus, hypercholesterolemia and smoking, only the coronary and carotid arteries, and the thoracic aorta were independent predictors of the designated endpoints. When examining the potential of calcification in the five arterial sites for predicting MACE, the difference in C-statistic was also most pronounced in these three sites, at 0.21 [95% confidence interval (CI) 0.16%–0.26%, P 
doi_str_mv 10.1093/ndt/gfac252
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2710970318</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfac252</oup_id><sourcerecordid>2710970318</sourcerecordid><originalsourceid>FETCH-LOGICAL-c278t-75094161a3f77697fbf7f25ff37fe1ad72abef3374204337acbd0728b0ce66d03</originalsourceid><addsrcrecordid>eNp9kc9u1DAQhy0EotvCiTvyCSGhUP_ZxAk3tIKCVIlLe44m9rg1JPFiOyv2xjv0KXgtnoSB3fbI6Sd5Pn0az4-xF1K8laLT57Mr5zcerKrVI7aS60ZUSrf1Y7aiqaxELboTdprzVyFEp4x5yk50I5qmE-2K_drEFGdIew6z4_ijJKjsw1MqSGFhtGGZeKYBZg6ZbxO6YEtMmUdP8-RC3EG2ywiJ4w7nkv_5ppgKjKHseZi5vSVtsPxbcDPuuQsZISPPBW7IKn__vKvfcSB3zFu0JeyQ23hLBkIWt3_GnngYMz4_5hm7_vjhavOpuvxy8Xnz_rKyyrSlMvTdtWwkaG9M0xk_eONV7b02HiU4o2BAr7VZK7GmADs4YVQ7CItN44Q-Y68PXlrk-4K59FPIFscRZoxL7pWhqxuhZUvomwNqaeec0PfbFCa6XC9F_7ebnrrpj90Q_fIoXoYJ3QN7XwYBrw5AXLb_Nf0Bc_mdlA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2710970318</pqid></control><display><type>article</type><title>Coronary and extra-coronary artery calcium scores as predictors of cardiovascular events and mortality in chronic kidney disease stages 1–5: a prospective cohort study</title><source>Oxford Journals Online</source><creator>Sørensen, Ida M H ; Bjergfelt, Sasha S ; Hjortkjær, Henrik Ø ; Kofoed, Klaus F ; Lange, Theis ; Feldt-Rasmussen, Bo ; Christoffersen, Christina ; Bro, Susanne</creator><creatorcontrib>Sørensen, Ida M H ; Bjergfelt, Sasha S ; Hjortkjær, Henrik Ø ; Kofoed, Klaus F ; Lange, Theis ; Feldt-Rasmussen, Bo ; Christoffersen, Christina ; Bro, Susanne</creatorcontrib><description>ABSTRACT Background Vascular calcification is a known risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, since there is a lack of studies examining several arterial regions at a time, we aimed to evaluate the risk of major adverse cardiovascular events (MACE) and all-cause mortality according to calcium scores in five major arterial sites. Methods This was a prospective study of 580 patients from the Copenhagen CKD Cohort. Multidetector computed tomography of the coronary and carotid arteries, the thoracic aorta, the abdominal aorta and the iliac arteries was used to determine vascular calcification at baseline. Calcium scores were divided into categories: 0, 1–100, 101–400 and &gt;400. Results During the follow-up period of 4.1 years a total of 59 cardiovascular events and 64 all-cause deaths occurred. In Cox proportional hazards models adjusted for age, sex, estimated glomerular filtration rate, hypertension, diabetes mellitus, hypercholesterolemia and smoking, only the coronary and carotid arteries, and the thoracic aorta were independent predictors of the designated endpoints. When examining the potential of calcification in the five arterial sites for predicting MACE, the difference in C-statistic was also most pronounced in these three sites, at 0.21 [95% confidence interval (CI) 0.16%–0.26%, P &lt; .001], 0.26 (95% CI 0.22%–0.3%, P &lt; .001) and 0.20 (95% CI 0.16%–0.24%, P &lt; .001), respectively. This trend also applied to all-cause mortality. Conclusions The overall results, including data on specificity, suggest that calcium scores of the coronary and carotid arteries have the most potential for identifying patients with CKD at high cardiovascular risk and for evaluating new therapies. Graphical Abstract Graphical Abstract</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfac252</identifier><identifier>PMID: 36066908</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Calcium ; Cardiovascular Diseases - complications ; Cardiovascular Diseases - etiology ; Coronary Artery Disease - complications ; Coronary Artery Disease - etiology ; Coronary Vessels ; Humans ; Prospective Studies ; Renal Insufficiency, Chronic - therapy ; Risk Factors ; Vascular Calcification - diagnostic imaging ; Vascular Calcification - etiology</subject><ispartof>Nephrology, dialysis, transplantation, 2023-05, Vol.38 (5), p.1227-1239</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c278t-75094161a3f77697fbf7f25ff37fe1ad72abef3374204337acbd0728b0ce66d03</cites><orcidid>0000-0003-3002-4188 ; 0000-0003-1057-5812 ; 0000-0003-3751-5203</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36066908$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sørensen, Ida M H</creatorcontrib><creatorcontrib>Bjergfelt, Sasha S</creatorcontrib><creatorcontrib>Hjortkjær, Henrik Ø</creatorcontrib><creatorcontrib>Kofoed, Klaus F</creatorcontrib><creatorcontrib>Lange, Theis</creatorcontrib><creatorcontrib>Feldt-Rasmussen, Bo</creatorcontrib><creatorcontrib>Christoffersen, Christina</creatorcontrib><creatorcontrib>Bro, Susanne</creatorcontrib><title>Coronary and extra-coronary artery calcium scores as predictors of cardiovascular events and mortality in chronic kidney disease stages 1–5: a prospective cohort study</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>ABSTRACT Background Vascular calcification is a known risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, since there is a lack of studies examining several arterial regions at a time, we aimed to evaluate the risk of major adverse cardiovascular events (MACE) and all-cause mortality according to calcium scores in five major arterial sites. Methods This was a prospective study of 580 patients from the Copenhagen CKD Cohort. Multidetector computed tomography of the coronary and carotid arteries, the thoracic aorta, the abdominal aorta and the iliac arteries was used to determine vascular calcification at baseline. Calcium scores were divided into categories: 0, 1–100, 101–400 and &gt;400. Results During the follow-up period of 4.1 years a total of 59 cardiovascular events and 64 all-cause deaths occurred. In Cox proportional hazards models adjusted for age, sex, estimated glomerular filtration rate, hypertension, diabetes mellitus, hypercholesterolemia and smoking, only the coronary and carotid arteries, and the thoracic aorta were independent predictors of the designated endpoints. When examining the potential of calcification in the five arterial sites for predicting MACE, the difference in C-statistic was also most pronounced in these three sites, at 0.21 [95% confidence interval (CI) 0.16%–0.26%, P &lt; .001], 0.26 (95% CI 0.22%–0.3%, P &lt; .001) and 0.20 (95% CI 0.16%–0.24%, P &lt; .001), respectively. This trend also applied to all-cause mortality. Conclusions The overall results, including data on specificity, suggest that calcium scores of the coronary and carotid arteries have the most potential for identifying patients with CKD at high cardiovascular risk and for evaluating new therapies. Graphical Abstract Graphical Abstract</description><subject>Calcium</subject><subject>Cardiovascular Diseases - complications</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - etiology</subject><subject>Coronary Vessels</subject><subject>Humans</subject><subject>Prospective Studies</subject><subject>Renal Insufficiency, Chronic - therapy</subject><subject>Risk Factors</subject><subject>Vascular Calcification - diagnostic imaging</subject><subject>Vascular Calcification - etiology</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQhy0EotvCiTvyCSGhUP_ZxAk3tIKCVIlLe44m9rg1JPFiOyv2xjv0KXgtnoSB3fbI6Sd5Pn0az4-xF1K8laLT57Mr5zcerKrVI7aS60ZUSrf1Y7aiqaxELboTdprzVyFEp4x5yk50I5qmE-2K_drEFGdIew6z4_ijJKjsw1MqSGFhtGGZeKYBZg6ZbxO6YEtMmUdP8-RC3EG2ywiJ4w7nkv_5ppgKjKHseZi5vSVtsPxbcDPuuQsZISPPBW7IKn__vKvfcSB3zFu0JeyQ23hLBkIWt3_GnngYMz4_5hm7_vjhavOpuvxy8Xnz_rKyyrSlMvTdtWwkaG9M0xk_eONV7b02HiU4o2BAr7VZK7GmADs4YVQ7CItN44Q-Y68PXlrk-4K59FPIFscRZoxL7pWhqxuhZUvomwNqaeec0PfbFCa6XC9F_7ebnrrpj90Q_fIoXoYJ3QN7XwYBrw5AXLb_Nf0Bc_mdlA</recordid><startdate>20230504</startdate><enddate>20230504</enddate><creator>Sørensen, Ida M H</creator><creator>Bjergfelt, Sasha S</creator><creator>Hjortkjær, Henrik Ø</creator><creator>Kofoed, Klaus F</creator><creator>Lange, Theis</creator><creator>Feldt-Rasmussen, Bo</creator><creator>Christoffersen, Christina</creator><creator>Bro, Susanne</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3002-4188</orcidid><orcidid>https://orcid.org/0000-0003-1057-5812</orcidid><orcidid>https://orcid.org/0000-0003-3751-5203</orcidid></search><sort><creationdate>20230504</creationdate><title>Coronary and extra-coronary artery calcium scores as predictors of cardiovascular events and mortality in chronic kidney disease stages 1–5: a prospective cohort study</title><author>Sørensen, Ida M H ; Bjergfelt, Sasha S ; Hjortkjær, Henrik Ø ; Kofoed, Klaus F ; Lange, Theis ; Feldt-Rasmussen, Bo ; Christoffersen, Christina ; Bro, Susanne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c278t-75094161a3f77697fbf7f25ff37fe1ad72abef3374204337acbd0728b0ce66d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Calcium</topic><topic>Cardiovascular Diseases - complications</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - etiology</topic><topic>Coronary Vessels</topic><topic>Humans</topic><topic>Prospective Studies</topic><topic>Renal Insufficiency, Chronic - therapy</topic><topic>Risk Factors</topic><topic>Vascular Calcification - diagnostic imaging</topic><topic>Vascular Calcification - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sørensen, Ida M H</creatorcontrib><creatorcontrib>Bjergfelt, Sasha S</creatorcontrib><creatorcontrib>Hjortkjær, Henrik Ø</creatorcontrib><creatorcontrib>Kofoed, Klaus F</creatorcontrib><creatorcontrib>Lange, Theis</creatorcontrib><creatorcontrib>Feldt-Rasmussen, Bo</creatorcontrib><creatorcontrib>Christoffersen, Christina</creatorcontrib><creatorcontrib>Bro, Susanne</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sørensen, Ida M H</au><au>Bjergfelt, Sasha S</au><au>Hjortkjær, Henrik Ø</au><au>Kofoed, Klaus F</au><au>Lange, Theis</au><au>Feldt-Rasmussen, Bo</au><au>Christoffersen, Christina</au><au>Bro, Susanne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary and extra-coronary artery calcium scores as predictors of cardiovascular events and mortality in chronic kidney disease stages 1–5: a prospective cohort study</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2023-05-04</date><risdate>2023</risdate><volume>38</volume><issue>5</issue><spage>1227</spage><epage>1239</epage><pages>1227-1239</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>ABSTRACT Background Vascular calcification is a known risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, since there is a lack of studies examining several arterial regions at a time, we aimed to evaluate the risk of major adverse cardiovascular events (MACE) and all-cause mortality according to calcium scores in five major arterial sites. Methods This was a prospective study of 580 patients from the Copenhagen CKD Cohort. Multidetector computed tomography of the coronary and carotid arteries, the thoracic aorta, the abdominal aorta and the iliac arteries was used to determine vascular calcification at baseline. Calcium scores were divided into categories: 0, 1–100, 101–400 and &gt;400. Results During the follow-up period of 4.1 years a total of 59 cardiovascular events and 64 all-cause deaths occurred. In Cox proportional hazards models adjusted for age, sex, estimated glomerular filtration rate, hypertension, diabetes mellitus, hypercholesterolemia and smoking, only the coronary and carotid arteries, and the thoracic aorta were independent predictors of the designated endpoints. When examining the potential of calcification in the five arterial sites for predicting MACE, the difference in C-statistic was also most pronounced in these three sites, at 0.21 [95% confidence interval (CI) 0.16%–0.26%, P &lt; .001], 0.26 (95% CI 0.22%–0.3%, P &lt; .001) and 0.20 (95% CI 0.16%–0.24%, P &lt; .001), respectively. This trend also applied to all-cause mortality. Conclusions The overall results, including data on specificity, suggest that calcium scores of the coronary and carotid arteries have the most potential for identifying patients with CKD at high cardiovascular risk and for evaluating new therapies. Graphical Abstract Graphical Abstract</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>36066908</pmid><doi>10.1093/ndt/gfac252</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-3002-4188</orcidid><orcidid>https://orcid.org/0000-0003-1057-5812</orcidid><orcidid>https://orcid.org/0000-0003-3751-5203</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0931-0509
ispartof Nephrology, dialysis, transplantation, 2023-05, Vol.38 (5), p.1227-1239
issn 0931-0509
1460-2385
language eng
recordid cdi_proquest_miscellaneous_2710970318
source Oxford Journals Online
subjects Calcium
Cardiovascular Diseases - complications
Cardiovascular Diseases - etiology
Coronary Artery Disease - complications
Coronary Artery Disease - etiology
Coronary Vessels
Humans
Prospective Studies
Renal Insufficiency, Chronic - therapy
Risk Factors
Vascular Calcification - diagnostic imaging
Vascular Calcification - etiology
title Coronary and extra-coronary artery calcium scores as predictors of cardiovascular events and mortality in chronic kidney disease stages 1–5: a prospective cohort study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T20%3A53%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Coronary%20and%20extra-coronary%20artery%20calcium%20scores%20as%20predictors%20of%20cardiovascular%20events%20and%20mortality%20in%20chronic%20kidney%20disease%20stages%201%E2%80%935:%20a%20prospective%20cohort%20study&rft.jtitle=Nephrology,%20dialysis,%20transplantation&rft.au=S%C3%B8rensen,%20Ida%20M%20H&rft.date=2023-05-04&rft.volume=38&rft.issue=5&rft.spage=1227&rft.epage=1239&rft.pages=1227-1239&rft.issn=0931-0509&rft.eissn=1460-2385&rft_id=info:doi/10.1093/ndt/gfac252&rft_dat=%3Cproquest_cross%3E2710970318%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c278t-75094161a3f77697fbf7f25ff37fe1ad72abef3374204337acbd0728b0ce66d03%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2710970318&rft_id=info:pmid/36066908&rft_oup_id=10.1093/ndt/gfac252&rfr_iscdi=true