International Medicine and Health Guidance News ›› 2022, Vol. 28 ›› Issue (8): 1042-1046.DOI: 10.3760/cma.j.issn.1007-1245.2022.08.002

• Special Column of Urology and Reproduction • Previous Articles     Next Articles

Assessment of coronary artery calcification and its relationship with cardiovascular events in patients with end-stage renal diseases

Xie Yingye, Zhong Haowen, Chen Li, Zhang Mengbi, Xie Na, Chen Jianhua, Liu Yufeng, Lai Yanhong, Su Xiaoyan   

  1. Department of Nephrology, TungWah Hospital of Sun Yat-sen University, Dongguan 523000, China
  • Received:2021-11-25 Online:2022-04-15 Published:2022-05-06
  • Contact: Su Xiaoyan, Email: suxiaoyan769@hotmail.com
  • Supported by:

    Key Project of Regional Joint Fund of Basic and Applied Basic Research Fund of Guangdong Province (2020B1515120037); 

    Dongguan Social Science and Technology Development Key Project (2018507150461629); 

    Dongguan Social Science and Technology Development General Project (2018507150461232)

终末期肾脏病患者冠状动脉钙化评估方法与心血管事件的关系

谢应业  钟浩文  陈丽  章梦璧  谢娜  陈建华  刘玉峰  赖艳红  苏晓燕   

  1. 中山大学附属东华医院肾内科,东莞 523000
  • 通讯作者: 苏晓燕,Email:suxiaoyan769@hotmail.com
  • 基金资助:

    广东省基础与应用基础研究基金项目区域联合基金重点项目(2020B1515120037);

    东莞市社会科技发展重点项目(2018507150461629);

    东莞市社会科技发展一般项目(2018507150461232)

Abstract:

Objective To analyze the assessment method of coronary artery calcification (CAC) in patients with end-stage renal diseases (ESRD) and its relationship with major adverse cardiovascular events (MACE). Methods From May 2018 to October 2020, 228 patients with ESRD from TungWah Hospital of Sun Yat-sen University were enrolled. The clinical characteristics of ESRD patients with CAC were analyzed. Logistic regression analysis was used to evaluate the assessment and forecast the efficiencies of CAC integral [Agatston (AS) integral, volume integral (VS integral), and mass integral (MS integral)] in CT reconstruction technique for the occurrence of MACE in the ESRD patients. Independent sample t test was used for inter-group comparison of the measurement data conforming to normal distribution, rank sum test was used for inter-group comparison of the measurement data conforming to abnormal distribution, and χ2 test was used for inter-group comparison of the count data. Results According to the occurrence of CAC, the ESRD patients were divided into a CAC group [164 cases, 108 males and 56 females, aged 61.00 (50.00, 71.00) years] and a non-CAC group [64 cases, 43 males and 21 females, aged 38.00 (31.00, 45.00) years]. The incidence of MACE in the CAC group was significantly higher than that in the non-CAC group [60.98% (100/164) vs. 21.87% (14/64)], with a statistically significant difference (P<0.001). In the CAC group, the three CAC integrals of the MACE subgroup were significantly higher than those of the non-MACE subgroup (AS integral: 4 267.0 vs. 725.3, P<0.001; MS integral: 3.2 vs. 2.7, P<0.001; VS integral: 4 732.0 vs. 881.9, P<0.001). Logistic regression analysis showed that AS integral, MS integral, VS integral, and albumin were all risk factors for MACE in the ESRD patients, among which MS integral and albumin were independent risk factors for MACE in the ESRD patients (all P<0.05). Conclusions ESRD patients with CAC have a high incidence of MACE. MS integral is an independent risk factor of MACE occurrence in ESRD patients, and might be applied to clinical monitoring of the occurrence and development of MACE in ESRD patients.

Key words: End-stage renal diseases, Coronary artery calcification, Calcification integral, Major adverse cardiovascular events, Risk factors

摘要: 目的 分析终末期肾脏病(ESRD)患者冠状动脉钙化(CAC)及其评估方法与主要心血管不良事件(MACE)的关系。方法 选取2018年5月至2020年10月在中山大学附属东华医院确诊为ESRD患者共228例,分析ESRD患者合并CAC的病例特点,并通过logistic回归法分析CAC评估方法CT重建技术中Agatston积分(AS积分)、质量积分(MS积分)和容积积分(VS积分)对ESRD患者发生MACE的评估和预测效能。符合正态分布的计量资料组间比较采用独立样本t检验,非正态分布的计量资料组间比较采用秩和检验,计数资料组间比较采用χ2检验。结果 ESRD患者根据有无发生CAC分为CAC组[164例,男108例、女56例,年龄61.00(50.00,71.00)岁]和non-CAC组[64例,男43例、女21例,年龄38.00(31.00,45.00)岁],CAC组发生MACE的比例较non-CAC组明显升高[60.98%(100/164)比21.87%(14/64)],差异有统计学意义(P<0.001)。而CAC组中,MACE亚组3种钙化积分均明显大于non-MACE亚组(AS积分:4 267.0比725.3,P<0.001;MS积分:3.2比2.7,P<0.001;VS积分:4 732.0比881.9,P<0.001)。logistic回归分析发现,AS积分、MS积分、VS积分、白蛋白均为ESRD患者发生MACE的危险因素,MS积分和白蛋白则为ESRD患者发生MACE的独立危险因素(均P<0.05)。结论 ESRD合并CAC患者MACE发生率高,反映CAC的MS积分是ESRD患者发生MACE的独立危险因素,或能应用于临床监测ESRD患者MACE的发生发展。

关键词: 终末期肾脏病, 冠状动脉钙化, 钙化积分, 主要不良心血管事件, 危险因素