Serum Sortilin Is Associated with Coronary Artery Calcification and Cardiovascular and Cerebrovascular Events in Maintenance Hemodialysis Patients

Objective: To analyze the role of serum sortilin in coronary artery calcification (CAC) and cardiovascular and cerebrovascular events (CCE) in maintenance hemodialysis (MHD) patients. Methods: One hundred eleven patients with MHD ≥3 months were included in this study. The general data, clinical features, hematological data, and medication history of the patients were recorded. Eighty-five cases were examined by vascular color Doppler ultrasound, cardiac color Doppler ultrasound, lateral lumbar radiography, and coronary artery calcification score. The patients were followed up for a median time of 45 months. The primary endpoint was CCE or death from a vascular event, and the role of sortilin in this process was analyzed. Results: Among 85 MHD patients, 51 cases (60.00%) had different degrees of CAC. There were significant differences in diabetes, dialysis time, serum phosphorus, calcium-phosphorus product, medical history of phosphate binders, sortilin, and carotid artery plaque between 4 different degrees of calcification groups (p < 0.05). Logistic regression analysis showed that diabetes (OR = 5.475; 95% CI: 1.794–16.71, p = 0.003), calcium-phosphorus product (OR = 2.953; 95% CI: 1.198–7.279, p = 0.019), and sortilin (OR = 1.475 per 100 pg/mL; 95% CI: 1.170–1.858, p = 0.001) were independent risk factors for CAC. During the follow-up, 28 cases of 111 patients (25.23%) suffered from CCE. There were significant differences in CCE between mild, moderate, and severe CAC groups and noncalcification groups (p < 0.05). Cox regression analysis showed that diabetes mellitus (HR 3.424; 95% CI: 1.348–8.701, p = 0.010), CAC (HR 5.210; 95% CI: 1.093–24.83, p = 0.038), and serum sortilin (HR = 8.588; 95% CI: 1.919–38.43, p = 0.005) were independent risk factors for CCE. Besides, we proposed a cutoff value of 418 pg/mL for serum sortilin level, which was able to predict the occurrence of CCE with 75.0% sensitivity and 71.9% specificity. The area under the curve was 0.778 (95% CI: 0.673–0.883). Conclusion: Sortilin is newly found to be independently associated with CAC and CCE in MHD patients.

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Circulating miRNA-29b and Sclerostin Levels Correlate with Coronary Artery Calcification and Cardiovascular Events in Maintenance Hemodialysis Patients

Cardiology Research and Practice ◽

10.1155/2021/9208634 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Jiqing He ◽

Mingjiao Pan ◽

Mingzhi Xu ◽

Ruman Chen

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

Serum Level ◽

Coronary Artery Calcification ◽

Cardiovascular Events ◽

Serum Levels ◽

Maintenance Hemodialysis ◽

Circulating Mirna ◽

Independent Risk Factors ◽

Hs Crp

Objective. Coronary artery calcification (CAC) is a common complication in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (MHD), and the extent of CAC is a predominant predictor of cardiovascular outcomes in MHD patients. In this study, we sought to uncover the relationship between circulating miRNA-29b, sclerostin levels, CAC, and cardiovascular events (CVEs) in MHD patients. Methods. This study recruited patients receiving MHD for at least three months in the Hainan General Hospital between January 2016 and June 2019, and all patients were followed up 24 months for CVEs. The serum level of sclerostin was determined by enzyme-linked immunosorbent assay (ELISA) and miRNA-29b expression by real-time qPCR (RT-qPCR). All patients received cardiac CT scans to evaluate CAC, and CAC scores were expressed in Agatston units. The MHD patients with CACs <100 were arranged into the CAC (<100) group, those with 100–400 CACs into the CAC (100–400) group, and those with CACs >400 into the CAC (>400) group. Net reclassification index (NRI) and integrated discrimination index (IDI) were calculated to assess the predictive performance of serum sclerostin level for the occurrence of CVEs. Results. Compared with the CAC (<100) group, the CAC (>400) group had higher proportions of older patients, hypertension and diabetes mellitus patients, longer dialysis duration, higher mean arterial pressure (MAP), higher levels of high-sensitivity C-reactive protein (hs-CRP), alkaline phosphatase (ALP), and phosphate ( P < 0.05 ). It was found that the CAC (100–400) and CAC (>400) groups exhibited higher serum levels of sclerostin but lower levels of miRNA-29b than the CAC (<100) group ( P < 0.05 ) and the CAC (>400) group had a higher level of sclerostin and a lower level of miRNA-29b than the CAC (100–400) group ( P < 0.05 ). The circulating level of miRNA-29b was negatively correlated with the serum level of sclerostin in MHD patients (r = −0.329, P < 0.01 ). The multivariate logistic regression analysis showed that hs-CRP, phosphate, sclerostin, and miRNA-29b were independent risk factors for CAC in MHD patients ( P < 0.05 , Table 2). ROC for prediction of CAC by sclerostin yielded 0.773 AUC with 95% CI 0.683–0.864 ( P < 0.01 ). As depicted by Kaplan–Meier curves of CVE incidence in MHD patients according to median sclerostin (491.88 pg/mL) and median miRNA-29b (Ct = 25.15), we found that serum levels of sclerostin and miRNA-29b were correlated with the incidence of CVEs in MHD patients. When a new model was used to predict the incidence of CVEs, NRI 95% CI was 0.60 (0.16–1.03) ( P < 0.05 ) and IDI 95% CI was 0.002 (−0.014 to 0.025) ( P < 0.05 ), suggesting that sclerostin added into the old model could improve the prediction of the incidence of CVEs. Conclusions. These data suggest that circulating miRNA-29b and sclerostin levels are correlated with CAC and incidence of CVEs in MHD patients. Higher sclerostin and lower miRNA-29b may serve as independent risk factors for the incidence of CVEs in MHD patients.

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Affiliation and Control During Marital Disagreement, History of Divorce, and Asymptomatic Coronary Artery Calcification in Older Couples

Psychosomatic Medicine ◽

10.1097/psy.0b013e31821188ca ◽

2011 ◽

Vol 73 (4) ◽

pp. 350-357 ◽

Cited By ~ 26

Author(s):

Timothy W. Smith ◽

Bert N. Uchino ◽

Paul Florsheim ◽

Cynthia A. Berg ◽

Jonathan Butner ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Calcification ◽

Older Couples ◽

History Of ◽

And Control

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Family history of premature coronary artery disease is not associated with coronary artery calcification

Atherosclerosis ◽

10.1016/j.atherosclerosis.2021.06.710 ◽

2021 ◽

Vol 331 ◽

pp. e231

Author(s):

G. Koulaouzidis ◽

D. Charisopoulou

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Family History ◽

Coronary Artery Calcification ◽

Premature Coronary Artery Disease ◽

History Of ◽

Artery Disease

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The role of Coronary Artery Calcification Score in lung cancer patients

European Journal of Radiology ◽

10.1016/j.ejrad.2021.110140 ◽

2021 ◽

pp. 110140

Author(s):

Valerio Nardone ◽

Alfonso Reginelli ◽

Giuseppina De Marco ◽

Teresa Di Pietro ◽

Roberta Grassi ◽

...

Keyword(s):

Lung Cancer ◽

Coronary Artery ◽

Cancer Patients ◽

Coronary Artery Calcification ◽

Coronary Artery Calcification Score ◽

Lung Cancer Patients ◽

Calcification Score

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Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication

Case Reports in Radiology ◽

10.1155/2016/4273780 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Rohit Dewan ◽

Anil K. Dasyam ◽

Henke Tan ◽

Alessandro Furlan

Keyword(s):

Doppler Ultrasound ◽

Renal Allograft ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Imaging Findings ◽

Unenhanced Ct ◽

Doppler Signals ◽

History Of ◽

Normal Blood Flow

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.

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