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Coronary Artery Calcification Score As the Determinant of Coronary Artery Disease in Chronic Kidney Disease Patients: A Preliminary Study Publisher



Moradi M1 ; Talebi A1 ; Shavakhi S2 ; Tarrahi MJ3 ; Meraji Far F4
Authors
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Authors Affiliations
  1. 1. Department of Radiology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Medical Students’ Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Epidemiology and Biostatistics, School of Health, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Iran
  4. 4. Alzahra Research Institute, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Source: ARYA Atherosclerosis Published:2024


Abstract

BACKGROUND: Coronary computed tomography angiography (CCTA) is a noninvasive cardiovascular imaging procedure that visualizes coronary artery calcifications (CAC), a marker of subclinical atherosclerosis. Due to different calcification patterns in patients with chronic kidney disease (CKD) compared to the general population, this study aims to present diagnostic cut-off values for CAC to detect early coronary artery disease (CAD) in CKD patients. METHODS: This cross-sectional study included 807 patients: 407 with CKD and 400 controls with normal kidney function who underwent CCTA during 2019-2021. CAC score measurements were performed for all left main coronary arteries to investigate CAD. The Coronary Artery Disease Reporting and Data System (CAD-RADS) was used as the gold standard to determine the value of CAC, and diagnostic values were measured. RESULTS: The number of female patients was 443 (54.9%), and 364 (45.1%) were male. The mean age in the case group was 63.95 ± 10.26 years, and in the control group, it was 53.80 ± 11.84 years. At the cut-off point of 85, the CAC score had a sensitivity and specificity of 84.7% and 83%, respectively, among patients with CKD to detect CAD (Area Under the Curve (AUC): 0.919, 95% CI: 0.89-0.94; P-value < 0.001). Considering a cut-point of 85 for CAC, the frequency of healthy subjects with CAD-RADS less than two was significantly higher than the cases (P-value = 0.012), while the two groups were similar regarding CAD-RADS 3-5 (P-value = 0.83). CONCLUSION: According to this study, the CAC score is a valuable means to detect CAD among CKD subjects. There is no significant difference in CAC between patients with substantial CAD-RADS in CKD and non-CKD patients. The cut-point of 85 for the CAC score was found valuable to diagnose CAD with over 80% sensitivity and specificity. © 2024, Isfahan University of Medical Sciences(IUMS). All rights reserved.
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