Evaluating the Independent Impact of Renal Function Decline on Coronary Artery Calcification in Patients Undergone Cardiac CT Scan

Background: Cardiovascular events are the leading global cause of death. Calcification of coronary arteries is a common complication of renal failure and the leading cause of death in this population. However, its multifactorial mechanism is not fully understood. Objectives: The current study aimed to, firstly, investigate the association between renal dysfunction and the calcification of coronary arteries in patients with severe and milder stages of renal failure and, secondly, to determine the role of this variable by eliminating the effect of established confounding factors. Methods: Following a retrospective design, 261 patients with cardiovascular risk factors or atypical symptoms were investigated. Estimated GFR (glomerular filtration rate) was calculated using both Cockcroft-Gault and MDRD equations. An ECG-gated multidetector CT scan was performed to calculate CACS (coronary artery calcification score) using the Agatston method. The presence of significant CAC (coronary artery calcification) was defined as CACS > 100. Univariate and multivariate analyses were performed using binary logistic regression. Results: A total of 134 cases were diagnosed with CAC, and the mean CACS was 83.4 ± 18. According to univariate analysis, older age, male gender, systolic and diastolic blood pressure, and higher TG levels were correlated with the degree of CAC. HbA1C showed a weak correlation with CACS (P-value = 0.04). Renal insufficiency resulted in increased CAC, and lower eGFR (calculated with both Cockgraft-Gault and MDRD equations) was associated with higher calcification (P-value < 0.01). Our analysis shows that serum Ca, P, LDL, and HDL levels do not have a significant influence on calcification changes. After adjusting for confounding factors, male sex, age, triglyceride level, and eGFR were recognized as independent risk factors for CACS ≥ 100, a marker of coronary artery atherosclerosis. However, HbA1C and systolic and diastolic blood pressure were no longer considered as factors that contribute to the risk of CAC. Conclusions: We observed a gradual and independent association between lower eGFR and higher CAC scores.

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Abstract P011: White Blood Cell Count in Young Adulthood and Coronary Artery Calcification in Early Middle Age: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽

10.1161/circ.125.suppl_10.ap011 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Lifang Hou ◽

Donald Lloyd-Jones ◽

Hongyan Ning ◽

Mark . D Huffman ◽

Myriam Fornage ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Coronary Artery ◽

Blood Cell ◽

Young Adulthood ◽

White Blood Cell ◽

Coronary Artery Calcification ◽

Middle Age ◽

Hdl Cholesterol ◽

Wbc Count

Background: White blood cell (WBC) count is associated with incident coronary heart disease (CHD). Coronary artery calcification (CAC) is a measure of subclinical atherosclerosis that predicts CHD events. Since data are sparse regarding the association of WBC count with future CAC, we examined the association of WBC count in early adulthood (age 18-30 yrs.) with the presence of CAC 15 or 20 years later (age 33-50 yrs.). Methods: We included CARDIA participants who had baseline data on risk factors and WBC counts, and participated in the Year (Y) 15 or Y20 examinations with CAC score information. We performed age-, sex-, and race-adjusted linear regression analyses to examine the cross-sectional association between baseline (Y0) WBC count (total and subtypes) and known CHD risk factors, including systolic blood pressure (SBP), BMI, smoking (packs/year), total and HDL-cholesterol. We used multiple logistic regressions to assess prospective associations between Y0 WBC count and the presence of CAC at Y15 and Y20. Results: Among 3094 participants, mean (SD) age at baseline was 25± 4 years, 57% were women and 45% were black. In total, 263 and 566 subjects had CAC score>0 at Y15 and Y20 examination, respectively. Y0 SBP, BMI, and smoking (p<0.001), and HDL-cholesterol (p=0.01) were significantly associated with Y0 total WBC counts. Compared to participants without CAC at Y20, those with CAC score>0 had higher Y0 counts (10 9 /L, SD) of total WBC (6.0 ± 1.8 vs. 6.2 ± 1.9, p=0.04), lymphocyte (2.16 ± 0.75 vs. 2.23 ± 0.76 p=0.05), and eosinophil (0.16 ± 0.13 vs. 0.18 ± 0.16, p<0.001). These counts were positively associated with the presence of Y20 CAC after adjusting for potential confounders ( Table 1 ). Similar patterns were observed for Y15 CAC (data not shown). Conclusion: Total WBC and certain subtype counts in young adulthood are significantly associated with presence of CAC 15 or 20 years later in early middle age. These findings suggest the possible involvement of WBC in the initiation and/or early development of atherosclerosis. Table 1. Y0 WBC counts and CAC presence at Y20 (OR (95% CI) per 1 x 10 9 /L WBC counts Model 1 * Model 2 ** Total WBC 1.24 (1.12, 1.37) 1.11 (1.00, 1.24) Monocyte 1.02 (0.93, 1.13) 0.96 (0.87, 1.07) Neutrophils 1.13 (0.99, 1.28) 1.06 (0.93, 1.21) Lymphocyte 1.16 (1.05, 1.28) 1.03 (0.93, 1.14) Eosinophil 1.17 (1.05, 1.29) 1.14 (1.02, 1.27) * Age, sex, race adjusted; ** Model 1 plus Y0 education, SBP, BMI, TC, HDL, smoking and blood pressure lowering medication use.

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Relationship Between Risk Factors of Coronary Heart Disease on The Amount of Lesioned Coronary Artery

Health Notions ◽

10.33846/hn31208 ◽

2019 ◽

Vol 3 (12) ◽

pp. 493-496

Author(s):

Monitrya Nababan ◽

Achmad Lefi ◽

Djohar Nuswantoro

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Relative Risk ◽

Coronary Arteries ◽

Disease Risk ◽

Smoking History ◽

P Value ◽

History Of

Objective: To determine the relationship of coronary heart disease traditional risk factors to the number of lesioned coronary arteries and calculate the relative risk. Methods: This study used an analytical research design with a retrospective cohort study design using patient catheterization report data. Data analysis was performed using the chi square test and relative risk in 449 individuals. Results: Based on the analysis results obtained p value 0.05 indicating no relationship between risk factors for coronary heart disease with the number of coronary arteries the lesions based on sex, history of hypertension and history of smoking. Conclusion: There is a relationship between age, history of diabetes mellitus, history of dyslipidemia and the number of coronary arteries that are lesions in patients with coronary heart disease and there is no relationship between sex, history of hypertension and smoking history with the number of coronary arteries that are lesions in patients with coronary heart disease. Keywords: single vessel disease; multivessel disease; coronary artery disease; risk factors CAD

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Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

The Heart Surgery Forum ◽

10.1532/hsf.1216 ◽

2015 ◽

Vol 18 (1) ◽

pp. 006

Author(s):

Hasan Reyhanoglu ◽

Kaan Ozcan ◽

Murat Erturk ◽

Fatih İslamoglu ◽

İsa Durmaz

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Renal Failure ◽

Coronary Artery ◽

Coronary Artery Bypass ◽

Bypass Surgery ◽

Artery Bypass ◽

Significant Risk ◽

High Morbidity ◽

Factors Associated

Objective: We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery. Methods: One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group (C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated. Results: Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while 26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P < .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively. Conclusion: Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.

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Mortality Risk Factors in Chronic Renal Failure Patients after Coronary Artery Bypass Grafting

Renal Failure ◽

10.1080/08860220701573525 ◽

2007 ◽

Vol 29 (7) ◽

pp. 823-828 ◽

Cited By ~ 5

Author(s):

Beril Akman ◽

Ayse Bilgic ◽

Gulsah Sasak ◽

Siren Sezer ◽

Atilla Sezgin ◽

...

Keyword(s):

Risk Factors ◽

Renal Failure ◽

Coronary Artery ◽

Chronic Renal Failure ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Mortality Risk ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting

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Association of Plasma MiRNA-204 and the Presence and Severity of Coronary Artery Calcification in Patients With Type 2 Diabetes

Angiology ◽

10.1177/0003319720984592 ◽

2021 ◽

pp. 000331972098459

Author(s):

Yao-dong Ding ◽

Yu-qiang Pei ◽

Rui-Wang ◽

Jia-xin Yang ◽

Ying-xin Zhao ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Characteristic Curve ◽

Glycosylated Hemoglobin ◽

The United Kingdom ◽

Traditional Risk Factors ◽

Plasma Microrna

We investigated the association between plasma microRNA (miR)-204 and coronary artery calcification (CAC) in patients with type 2 diabetes mellitus (T2DM). We consecutively enrolled 179 individuals with T2DM who underwent coronary computed tomography at Anzhen Hospital from January 2015 to September 2016. The CAC score (CACS) was expressed in Agatston units and >10 Hounsfield units were defined as CAC-positive status. Significant CAC was observed in 98 (54.7%) patients. Plasma miR-204 levels (relative expression) were significantly lower in patients with significant CAC than controls (1.001 ± 0.100 vs 0.634 ± 0.211, P < .001). Plasma miR-204 levels were also negatively correlated with the glycosylated hemoglobin A1c (HbA1c) level (r = −0.702, P < .001), CACS (r = −0.710, P < .001), and the United Kingdom Prospective Diabetes Study (UKPDS) score (r = −0.355, P < .001). After multivariate logistic analyses, plasma miR-204 levels were still significantly and independently associated with the presence of CAC (odds ratio = 0.103, CI = 0.018-0.583, P < .001) after adjustment for conventional risk factors. Receiver operating characteristic curve analysis showed that plasma miR-204 levels can predict the severity and extent of CAC, and the specificity was higher than that of the traditional risk factors UKPDS score and HbA1c. In conclusion, the downregulation of miR-204 was independently associated with CAC in patients with T2DM.

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Genetic polymorphisms associated with carotid artery intima-media thickness and coronary artery calcification in women of the Kronos Early Estrogen Prevention Study

Physiological Genomics ◽

10.1152/physiolgenomics.00114.2012 ◽

2013 ◽

Vol 45 (2) ◽

pp. 79-88 ◽

Cited By ~ 26

Author(s):

Virginia M. Miller ◽

Tanya M. Petterson ◽

Elysia N. Jeavons ◽

Abhinita S. Lnu ◽

David N. Rider ◽

...

Keyword(s):

Coronary Artery ◽

Carotid Artery ◽

Coronary Artery Calcification ◽

Multiple Testing ◽

Intima Media Thickness ◽

Chromosome 17 ◽

European Ancestry ◽

P Value ◽

Prevention Study ◽

Media Thickness

Menopausal hormone treatment (MHT) may limit progression of cardiovascular disease (CVD) but poses a thrombosis risk. To test targeted candidate gene variation for association with subclinical CVD defined by carotid artery intima-media thickness (CIMT) and coronary artery calcification (CAC), 610 women participating in the Kronos Early Estrogen Prevention Study (KEEPS), a clinical trial of MHT to prevent progression of CVD, were genotyped for 13,229 single nucleotide polymorphisms (SNPs) within 764 genes from anticoagulant, procoagulant, fibrinolytic, or innate immunity pathways. According to linear regression, proportion of European ancestry correlated negatively, but age at enrollment and pulse pressure correlated positively with CIMT. Adjusting for these variables, two SNPs, one on chromosome 2 for MAP4K4 gene (rs2236935, β = 0.037, P value = 2.36 × 10−06) and one on chromosome 5 for IL5 gene (rs739318, β = 0.051, P value = 5.02 × 10−05), associated positively with CIMT; two SNPs on chromosome 17 for CCL5 (rs4796119, β = −0.043, P value = 3.59 × 10−05; rs2291299, β = −0.032, P value = 5.59 × 10−05) correlated negatively with CIMT; only rs2236935 remained significant after correcting for multiple testing. Using logistic regression, when we adjusted for waist circumference, two SNPs (rs11465886, IRAK2, chromosome 3, OR = 3.91, P value = 1.10 × 10−04; and rs17751769, SERPINA1, chromosome 14, OR = 1.96, P value = 2.42 × 10−04) associated positively with a CAC score of >0 Agatston unit; one SNP (rs630014, ABO, OR = 0.51, P value = 2.51 × 10−04) associated negatively; none remained significant after correcting for multiple testing. Whether these SNPs associate with CIMT and CAC in women randomized to MHT remains to be determined.

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Abstract 57: Risk Factors For Severe Reductions In Blood Pressure After Treatment Of Severe Inpatient Hypertension

Hypertension ◽

10.1161/hyp.78.suppl_1.57 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Lama Ghazi ◽

Fan Li ◽

Eric Chen ◽

Michael Simonov ◽

Yu Yamamoto ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cohort Study ◽

Hospital Admission ◽

Antihypertensive Treatment ◽

Treatment Guidelines ◽

P Value ◽

Antihypertensive Medications ◽

Black Race ◽

Oral Medications

Background: Incident severe HTN during hospitalization is far more common than admission for HTN, however treatment guidelines are lacking. Severe inpatient HTN is poorly studied, therefore our goal is to characterize inpatients who develop severe HTN and assess BP response to antihypertensive treatment. Methods: This is a cohort study of adults admitted for reasons other than HTN and developed severe HTN within a single healthcare system. We defined severe inpatient HTN as the first documentation of BP elevation (>180 systolic or >110 diastolic) at least 1 hour after hospital admission. Treatment was defined as receiving antihypertensive medications within 6 hours of BP elevation. We studied the association between treatment and BP drop ≥30%. Results: Among 224,265 hospitalized adults, 23,147 developed severe HTN of which 40% were treated. Compared to inpatients who did not develop severe HTN, those who did were older, more commonly women and Black, and had more comorbidities. Of the treated and untreated patients, 45.5 and 46.4% had a MAP drop ≥30% (p-value= 0.2). Risk factors for severe MAP drop include older age, Black race, HTN, and diabetes. Additionally, treatment vs. no treatment and treatment with intravenous vs. oral medications were associated with greater odds of MAP drop ≥30% ( Table 1 ). Conclusion: While there was no difference in the proportion of treated and untreated patients with severe MAP reduction, after adjustment for factors independently associated with HTN we found that treatment was associated with severe BP drop. Further research is needed to phenotype inpatients with severe HTN to help establish treatment guidelines.

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ASSESSMENT OF RISK FACTORS FOR THE PROGRESSION OF CORONARY ARTERY CALCIFICATION IN ASYMPTOMATIC SUBJECTS: RESULTS FROM THE KOREA INITIATIVES ON CORONARY ARTERY CALCIFICATION (KOICA) REGISTRY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)32215-0 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1674

Author(s):

Ji Hyun Lee ◽

Kisang Yoo ◽

David Sung ◽

Donghee Han ◽

Hyeonju Jung ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Asymptomatic Subjects

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Risk factors for death among critically ill patients with acute renal failure

Sao Paulo Medical Journal ◽

10.1590/s1516-31802006000500004 ◽

2006 ◽

Vol 124 (5) ◽

pp. 257-263 ◽

Cited By ~ 15

Author(s):

Geraldo Bezerra da Silva Júnior ◽

Elizabeth De Francesco Daher ◽

Rosa Maria Salani Mota ◽

Francisco Albano Menezes

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Mechanical Ventilation ◽

Renal Failure ◽

Acute Renal Failure ◽

Intensive Care ◽

Liver Failure ◽

Critically Ill ◽

Critically Ill Patients ◽

Urine Volume

CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.

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