Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy
Background. The prevalence of coronary artery stenosis (CAS) at the initiation of renal replacement therapy (RRT) in chronic kidney disease (CKD) patients has not been fully elucidated. Although coronary angiography is the gold standard in diagnosing CAS its invasiveness and economic burden lead to...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/916354 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832563254841311232 |
|---|---|
| author | Jung Eun Lee Yong Kyu Lee Eun Jeong Choi Ji Sun Nam Byoung Wook Choi Beom Seok Kim |
| author_facet | Jung Eun Lee Yong Kyu Lee Eun Jeong Choi Ji Sun Nam Byoung Wook Choi Beom Seok Kim |
| author_sort | Jung Eun Lee |
| collection | DOAJ |
| description | Background. The prevalence of coronary artery stenosis (CAS) at the initiation of renal replacement therapy (RRT) in chronic kidney disease (CKD) patients has not been fully elucidated. Although coronary angiography is the gold standard in diagnosing CAS its invasiveness and economic burden lead to searching for a noninvasive alternative method. In this study, we evaluated the prevalence of CAS by multidetector row computed tomography (MDCT) and related risk factor to articulate the usefulness of MDCT. Method. Seventy-four asymptomatic CKD patients who began dialysis were evaluated with echocardiography and MDCT. The patients were stratified into two groups according to CAS and coronary artery calcification score (CACS) by MDCT to detect silent CAS and evaluate its predictability for cardiac events. Results. CAS was seen in 24 (32.4%) of 74 asymptomatic CKD patients on MDCT. Both groups showed increasing frequencies of CAS with age (P<0.01), presence of diabetes (P<0.05), uric acid level (P<0.01), and calcium score (P<0.01). Multiple regression analysis revealed that age and uric acid level were independent risk factors for CAS and high CACS in asymptomatic CKD patients at the initiation of dialysis. Patients with both CAS and high CACS were presented with higher cardiac events rates compared to those without any of them. In Cox regression model, age and the presence of CAS and high CACS on MDCT were an independent risk factor for cardiac events in these patients. Conclusion. We showed that CAS was highly seen in asymptomatic CKD patients starting dialysis. Moreover, both high CACS and CAS on MDCT might predict cardiac events in these patients and MDCT can be a useful screening tool for evaluating coronary artery disease and predicting cardiovascular mortality noninvasively. |
| format | Article |
| id | doaj-art-ee0377200bf946edb960c439e00c5ed9 |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-ee0377200bf946edb960c439e00c5ed92025-02-03T01:20:45ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/916354916354Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement TherapyJung Eun Lee0Yong Kyu Lee1Eun Jeong Choi2Ji Sun Nam3Byoung Wook Choi4Beom Seok Kim5Department of Internal Medicine, Yonsei University, College of Medicine, Seoul 120-752, Republic of KoreaNephrology Division, Department of Internal Medicine, NHIC, Ilsan Hospital, Goyang 410-719, Republic of KoreaDepartment of Radiology, Yonsei University, College of Medicine, Seoul 120-752, Republic of KoreaDepartment of Internal Medicine, Yonsei University, College of Medicine, Seoul 120-752, Republic of KoreaDepartment of Radiology, Yonsei University, College of Medicine, Seoul 120-752, Republic of KoreaDepartment of Internal Medicine, Yonsei University, College of Medicine, Seoul 120-752, Republic of KoreaBackground. The prevalence of coronary artery stenosis (CAS) at the initiation of renal replacement therapy (RRT) in chronic kidney disease (CKD) patients has not been fully elucidated. Although coronary angiography is the gold standard in diagnosing CAS its invasiveness and economic burden lead to searching for a noninvasive alternative method. In this study, we evaluated the prevalence of CAS by multidetector row computed tomography (MDCT) and related risk factor to articulate the usefulness of MDCT. Method. Seventy-four asymptomatic CKD patients who began dialysis were evaluated with echocardiography and MDCT. The patients were stratified into two groups according to CAS and coronary artery calcification score (CACS) by MDCT to detect silent CAS and evaluate its predictability for cardiac events. Results. CAS was seen in 24 (32.4%) of 74 asymptomatic CKD patients on MDCT. Both groups showed increasing frequencies of CAS with age (P<0.01), presence of diabetes (P<0.05), uric acid level (P<0.01), and calcium score (P<0.01). Multiple regression analysis revealed that age and uric acid level were independent risk factors for CAS and high CACS in asymptomatic CKD patients at the initiation of dialysis. Patients with both CAS and high CACS were presented with higher cardiac events rates compared to those without any of them. In Cox regression model, age and the presence of CAS and high CACS on MDCT were an independent risk factor for cardiac events in these patients. Conclusion. We showed that CAS was highly seen in asymptomatic CKD patients starting dialysis. Moreover, both high CACS and CAS on MDCT might predict cardiac events in these patients and MDCT can be a useful screening tool for evaluating coronary artery disease and predicting cardiovascular mortality noninvasively.http://dx.doi.org/10.1155/2013/916354 |
| spellingShingle | Jung Eun Lee Yong Kyu Lee Eun Jeong Choi Ji Sun Nam Byoung Wook Choi Beom Seok Kim Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy The Scientific World Journal |
| title | Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy |
| title_full | Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy |
| title_fullStr | Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy |
| title_full_unstemmed | Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy |
| title_short | Usefulness of Multidetector Row Computed Tomography for Predicting Cardiac Events in Asymptomatic Chronic Kidney Disease Patients at the Initiation of Renal Replacement Therapy |
| title_sort | usefulness of multidetector row computed tomography for predicting cardiac events in asymptomatic chronic kidney disease patients at the initiation of renal replacement therapy |
| url | http://dx.doi.org/10.1155/2013/916354 |
| work_keys_str_mv | AT jungeunlee usefulnessofmultidetectorrowcomputedtomographyforpredictingcardiaceventsinasymptomaticchronickidneydiseasepatientsattheinitiationofrenalreplacementtherapy AT yongkyulee usefulnessofmultidetectorrowcomputedtomographyforpredictingcardiaceventsinasymptomaticchronickidneydiseasepatientsattheinitiationofrenalreplacementtherapy AT eunjeongchoi usefulnessofmultidetectorrowcomputedtomographyforpredictingcardiaceventsinasymptomaticchronickidneydiseasepatientsattheinitiationofrenalreplacementtherapy AT jisunnam usefulnessofmultidetectorrowcomputedtomographyforpredictingcardiaceventsinasymptomaticchronickidneydiseasepatientsattheinitiationofrenalreplacementtherapy AT byoungwookchoi usefulnessofmultidetectorrowcomputedtomographyforpredictingcardiaceventsinasymptomaticchronickidneydiseasepatientsattheinitiationofrenalreplacementtherapy AT beomseokkim usefulnessofmultidetectorrowcomputedtomographyforpredictingcardiaceventsinasymptomaticchronickidneydiseasepatientsattheinitiationofrenalreplacementtherapy |