0141: Topography of the coronary tree calcification in hemodialysis

Abstract

Cardiovascular disease is the first leading cause of death in hemodialysis. On these patients, cardiovascular calcifications occur at an earlier age and are developing faster than in the general population. Forty-nine patients on chronic hemodialysis, 26 men and 23 women, mean age 56.4 years, with a mean duration of 85 months on hemodialysis underwent screening for coronary calcification (CC) by a 64 slide cardioscanner with ECG synchronization and without contrast injection. CC were studied at the anterior inter ventricular artery (AIV), the right coronary artery (RCA), the left coronary artery (LCA), the circumflex artery (Cx), the diagonal artery (Diag) and the posterior inter ventricular artery (PIA). Agatston oronary calcium score (ACCS) was calculated by a pre supplied software. Coronary calcification concerned 69.4% of cases and were distributed as follows: 69.4% AIV, RCA 36.7%, 32.7% Cx, Diag 29.6% 20.4% LCA, PIA 8.2%. CC sat in one artery in 22.4% of cases, in 2, 3 or 5 arteries in 10.2% of cases, respectively, in 4 arteries in 14.3% of cases and at 6 divisions in one patient. The mean ACCS was 331.1, and 522.2 in the 10 patients treated for ischemic heart disease (p = 0.09). The mean ACCS by coronary division was: AIV 88.5, 69.8 CX, RCA 46.6, 15.8 Diag, LCA 6, PIA 2.8. Coronary calcification were significantly associated with conventional cardiovascular risk factors (age, male sex, systolic blood pressure, diabetes, history of ischemic heart disease). In this study, the topography of CC is superimposable to coronary atherosclerosis with which CC share several risk factors. Autopsy studies confirm that CC in patients with renal failure are more intense and are associated with more complex histological alterations in comparison with general population. Other studies confirm that total and individual coronary artery calcium scores are independent predictors of mortality in hemodialysis patients Our results confirm the high prevalence of CC in hemodialysis and encourage early and regular screening.