scholarly journals ASSOCIATION BETWEEN PRE-TRANSPLANT MEDIAL ARTERIAL CALCIFICATION AND EARLY POST-KIDNEY TRANSPLANT HYPERTENSION FROM A PROPENSITY SCORE WEIGHTING ANALYSIS

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e295-e296
Author(s):  
Ekamol Tantisattamo ◽  
Natnicha Leelaviwat ◽  
Natchaya Polpichai ◽  
Chawit Lopimpisuth ◽  
Sakditad Saowapa ◽  
...  
Keyword(s):  
Propensity Score ◽  
Kidney Transplant ◽  
Arterial Calcification ◽  
Propensity Score Weighting ◽  
Medial Arterial Calcification

Abstract P187: Pre-kidney Transplant Medical Arterial Calcification as a Risk for Post-transplant Mortality by a Propensity Score Weighting Analysis

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Ekamol Tantisattamo ◽  
Natnicha Leelaviwat ◽  
Chawit Lopimpisuth ◽  
Sakditad Saowapa ◽  
Natchaya Polpichai ◽  
...  
Keyword(s):  
Propensity Score ◽  
Arterial Calcification ◽  
Renal Transplant Recipients ◽  
Weighting Method ◽  
Post Transplant ◽  
Propensity Score Weighting ◽  
Increased Risk ◽  
Dialysis Vintage ◽  
Study Population ◽  
Medial Arterial Calcification

Introduction: Medial arterial calcification (MAC) detected in the breast by mammography (MG) is exclusively medial and associated with cardiovascular mortality in end-stage renal disease (ESRD). This association is unclear in renal transplant recipients (RTR). Hypothesis: By comparing groups of study population balanced by propensity score weighting method, MAC is associated with an increased risk of post-transplant mortality. Methods: Female RTR was divided into 2 groups per presence or absence of pre-transplant MAC examined from MG (MAC and non-MAC), and both groups was balanced with by PS weighting leading to a new study population. Association between MAC and post-transplant mortality of the new study population was examined by multi-variable logistic regression analysis. Results: Of 51 patients, mean age±SD was 57.08±10.47 years old. The majority were white (54.9%) followed by African American (35.3%) and others (9.8%). Incidence rate of mortality was 0.0307 person-years. Median time to follow-up was 3.95 years (range 0.22 to 6.37). Among 20 patients in MAC group, 5 patients died; whereas, only 1 out of 31 patients in non-MAC died (25% vs. 3.23%, p 0.029). Baseline characteristics of both groups were not equal. After using PS weights with generalized boosted modeling, new study population’s characteristics were balanced (Figure 1). MAC is associated with 5.97 times higer the odd of morality compared to non-MAC, but the association was not significant (OR 5.97; 95%CI 0.61, 58.77). After adjusted for age, race, causes of ESRD, dialysis modality, dialysis vintage, donor type, donor age, and type of immunosuppressive medications, the magnitude of the association was increased and becomes significant (OR 38.40; 95%CI 2.44, 604.54). Conclusions: Similar to ESRD, MAC remains associated with higher mortality in RTR and this association is confirmed by well-matched study population. Prevention of pre-transplant MAC should be pursued to mitigate poor post-transplant outcomes.

scholarly journals Pretransplant Hypoalbuminemia As A Predictor of Medical Arterial Calcification During Waiting List Pre‐Kidney Transplant Period: A Propensity Score Weighting Analysis

2020 ◽  
Vol 34 (S1) ◽  
pp. 1-1
Author(s):  
Ekamol Tantisattamo ◽  
Natnicha Leelaviwat ◽  
Chawit Lopimpisuth ◽  
Sakditad Saowapa ◽  
Natchaya Polpichai ◽  
...  
Keyword(s):  
Propensity Score ◽  
Kidney Transplant ◽  
Waiting List ◽  
Arterial Calcification ◽  
Propensity Score Weighting

Abstract 13571: Association Between Pre-kidney Transplantation Medial Arterial Calcification Andpost-transplant Visit-to-visit Blood Pressure Variability: A Propensity Score Matching Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ekamol Tantisattamo ◽  
Sakditad Saowapa ◽  
Natnicha Leelaviwat ◽  
Busara Songtanin ◽  
Chawit Lopimpisuth ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Blood Pressure Variability ◽  
Mineral Metabolism ◽  
Statistical Significance ◽  
Mean Difference ◽  
Absolute Difference ◽  
Arterial Calcification ◽  
Medial Arterial Calcification

Introduction: Arterial calcification is associated with vascular stiffness, which manifests with visit-to-visit blood pressure variability (VVBPV). Although media arterial calcification (MAC) is significantly associated with poor cardiovascular outcomes in kidney patients, the association in kidney transplant (KT) patients is unknown. Hypothesis: We hypothesize that MAC is associated with VVBPV in long-tern post-KT. Methods: Since MAC, which is detected from mammogram (MG) and determined by linear calcified breast arteries, is exclusively medial, female KT patients with ≥1 MG during pre-KT period were included in this study. VVBPV was examined by average successive variability (ASV), which is the average absolute difference between successive BP measured at 4, 12, 24, 36, and 48 weeks post-KT. After balancing patients with and without MAC by using propensity score matching based on age, diabetes, and obesity status, the association between MAC and systolic and diastolic VVBPV (VVSBPV and VVDBPV) at 48 weeks post-KT was tested by multiple linear regression (Figure1A&1B). Results: Of 51 patients, mean age±SD is 54±12 years, 21 had diabetes, and 21 were obese. Mean duration of follow-up was 47±9 years. Among 20 patients with MAC, mean VVSBPV was 20±14 mmHg; whereas, VVSBPV in non-MG group was 14±8 mmHg (mean difference -6± 3.0, p 0.06, 95%CI -12.03, 0.15). Mean VVDBPV in MG and non-MG groups were 12±5 and 11±5.6 mmHg, respectively (mean difference -1±1.6, p 0.41, 95%CI -4.44, 1.86). Laboratory-related bone and mineral metabolism were not different between both groups. On average, MG group had 8 mmHg higher VVSBPV compared to non-MG group (Coef. 3.62, p 0.02, 95%CI 1.16, 15.34). The MG group remained having higher VVDBPV but the magnitude of the association decreased and no statistical significance (Coef. 0.58, p 0.83, 95%CI -4.58, 5.73). Conclusions: Similar to non-transplant patients, KT recipients with pre-KT MAC had significant higher VVSBPV at the late post-KT.

Effect of medial arterial calcification on O2 supply to exercising diabetic feet

Diabetes ◽  
1990 ◽  
Vol 39 (8) ◽  
pp. 938-941 ◽  
Author(s):  
E. Chantelau ◽  
X. Y. Ma ◽  
S. Herrnberger ◽  
C. Dohmen ◽  
P. Trappe ◽  
...  
Keyword(s):  
Arterial Calcification ◽  
O2 Supply ◽  
Medial Arterial Calcification

Association of infrapopliteal medial arterial calcification with lower-limb amputations in high-risk patients: A systematic review and meta-analysis

2020 ◽  
pp. 1358863X2097973
Author(s):  
Fabrizio Losurdo ◽  
Roberto Ferraresi ◽  
Alessandro Ucci ◽  
Anna Zanetti ◽  
Giacomo Clerici ◽  
...  
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
Lower Limb ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Arterial Calcification ◽  
High Risk Patients ◽  
Patients With Diabetes ◽  
Risk Patients ◽  
Medial Arterial Calcification

Medial arterial calcification (MAC) is a known risk factor for cardiovascular morbidity. The association between vascular calcifications and poor outcome in several vascular districts suggest that infrapopliteal MAC could be a risk factor for lower-limb amputation (LLA). This study’s objective is to review the available literature focusing on the association between infrapopliteal MAC and LLA in high-risk patients. The PubMed and Embase databases were systematically searched. We selected original studies reporting the association between infrapopliteal MAC and LLAs in patients with diabetes and/or peripheral artery disease (PAD). Estimates were pooled using either a fixed-effects or a random-effects model meta-analysis. Heterogeneity was evaluated using the Q and I2 statistics. Publication bias was investigated with a funnel plot and Egger test. The trim-and-fill method was designed to estimate the possibly missing studies. Influence analysis was conducted to search studies influencing the final result. Test of moderators was used to compare estimates in good versus non-good-quality studies. Fifteen articles satisfied the selection criteria ( n = 6489; median follow-up: 36 months). MAC was significantly associated with LLAs (pooled adjusted risk ratio (RR): 2.27; 95% CI: 1.89–2.74; I2 = 25.3%, Q-test: p = 0.17). This association was kept in the subgroup of patients with diabetes (RR: 2.37; 95% CI: 1.76–3.20) and patients with PAD (RR: 2.48; 95% CI: 1.72–3.58). The association was maintained if considering as outcome only major amputations (RR: 2.11; 95% CI: 1.46–3.06). Our results show that infrapopliteal MAC is associated with LLAs, thus suggesting MAC as a possible new marker of the at-risk limb.

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