Tohoku J. Exp. Med., 2015 February, 235(2)

Vascular Calcification on Plain Radiographs Is Related with the Severity of Lesions Detected by Coronary Angiography in Dialysis Patients

HWA SEONG NAM,¹ SU MI LEE,¹ EU GENE JEONG,¹ DONG YEOL LEE,¹ YOUNG KI SON,¹ SEONG EUN KIM,¹ SEUK-HEE CHUNG,² YOUNG-RAK CHO,¹ JONG-SUNG PARK,¹ SUNG WOOK LEE,¹ MYUNG HWAN NOH¹ and WON SUK AN^1,3

¹Department of Internal Medicine, Dong-A University, Busan, Korea
²Department of Internal Medicine, Ulsan Central Hospital, Ulsan, Korea
³Institute of Medical Science, Dong-A University College of Medicine, Busan, Korea

Coronary artery disease (CAD) is a primary cause of mortality and morbidity in dialysis patients. However, it is difficult to select the proper point for coronary angiographic procedure, because dialysis patients frequently do not display typical symptoms. Vascular calcification (VC) scores of artery or aorta on plain radiographs are associated with CAD events and may be predictive of CAD in dialysis patients. Therefore, we evaluated whether high or meaningful VC scores on plain radiographs are related with the severity of lesions detected by coronary angiography (CAG) in dialysis patients. We retrospectively enrolled dialysis patients who underwent CAG and checked several plain radiographs within one year before or after CAG. Significant VC is defined as high or meaningful VC scores, such as long abdominal aortic calcification and medial artery calcification on feet. Of all 55 patients, 41 patients (74.5%) exhibited significant VC on plain radiographs and 23 patients (41.8%) underwent stent insertion. Among the 23 patients, longer stents were used in 18 patients with significant VC (34.1 ± 19.5 mm vs. 16.6 ± 15.2 mm, P = 0.029). Patients with significant VC showed higher prevalence rate of severe coronary artery calcification (P = 0.007) and diffuse/tubular stenosis (P = 0.012), detected by CAG, than those without significant VC. Thus, high or meaningful VC scores on plain radiographs were associated with the degree of calcification or stenosis detected by CAG. In conclusion, VC scores on plain radiographs may be predictive of calcification or stenosis of coronary artery before CAG in dialysis patients.

keywords —— coronary angiography; coronary artery disease; hemodialysis; peritoneal dialysis; vascular calcification

© 2015 Tohoku University Medical Press

===============================

Tohoku J. Exp. Med., 2015, 235, 135-144

Correspondence: Won Suk An, M.D., Ph.D., Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Republic of Korea.

e-mail: anws@dau.ac.kr