Prognostic Value Of Coronary Calcification For Major Adverse Cardiovascular Events In Patients With End-Stage Renal Failure Based On Routine Chest CT

Objective: The purpose of this study was investigated the predictive value of coronary artery calcification score(CACS)based on routine chest CT for major cardiovascular adverse events in patients with end-stage renal failure(ESRD).Methods: 81 patients with ESRD(mean age: 49.27±12.72 years,49 males)were collected.CAC was quantified by conventional chest CT and patients were followed up(median follow-up time: 40 months).A total of 14 patients happened MACE.Patients with ESRD were divided into two groups according to whether CAC was present in routine chest CT images,and the independent risk factors of CAC were analyzed by multivariate binary logistic regression,and the correlation between the continuous variable coronary artery calcification score(CACS)and laboratory and clinical indicators was analyzed by Pearson or Spearman correlation analysis.Coronary artery calcium score Kaplan-Meier survival curve and Log-Rank test were used to study the influence of CAC on the occurrence of MACE.Cox risk regression model was used to evaluate the correlation between continuous variable CACS and the occurrence of MACE after adjusting for confounding factors.Results: During a median follow-up period of 40 months,14 patients(17.3%)happened MACE.The results of inter-group comparison showed that compared with the non-CAC group,the CAC group was older,the Platelet-to-Lymphocyte ratio(PLR),the Neutrophilto-Lymphocyte ratio(NLR)were higher,and the vertebral bone density(VBD)was lower,and there was a significant difference between the two groups(P<0.05).Binary logistic regression analysis showed that dialysis time(OR=1.015,95% CI: 1.001-1.029,P=0.04)and age(OR=1.04,95% CI: 1.049-1.161,P<0.001)were independent risk factors for the occurrence of CAC in ESRD patients.Binary logistic regression analysis showed that dialysis time(OR=1.015,95% CI: 1.001-1.029,P=0.04)and age(OR=1.04,95% CI: 1.049-1.161,P<0.001)were independent risk factors for the occurrence of CAC in ESRD patients.Univariate correlation analysis of continuous variable CACS showed that age(r=0.473,P<0.001),PLR(r=0.276,P=0.013)were positively correlated with CACS;Cr(r=-0.245,P=0.028),VBD(r=-0.345,P=0.002),were negatively correlated with CACS.According to Kaplan-Meier curve and log-rank test(HR=9.315,P=0.008),the cumulative incidence of MACE events in ESRD population with CAC was higher than that in non-CAC population.After adjusting for age and diabetes with COX proportional risk model,CACS increased(HR=1.656,95% CI: 1.076-2.551,P=0.022).ESRD patients had an increased risk of MACE.Conclusion: CAC based on routine chest CT scan has certain predictive value for the risk of MACE in ESRD patients,and there is a certain correlation between CAC in ESRD patients and PLR,NLR inflammatory indicators and bone mineral density.