Journal Article

Coronary artery calcification and coronary flow velocity in haemodialysis patients

Yasar Caliskan, Mustafa Demirturk, Abdullah Ozkok, Berna Yelken, Tamer Sakaci, Huseyin Oflaz, Abdulkadir Unsal and Alaattin Yildiz

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 25, issue 8, pages 2685-2690
Published in print August 2010 | ISSN: 0931-0509
Published online February 2010 | e-ISSN: 1460-2385 | DOI:
Coronary artery calcification and coronary flow velocity in haemodialysis patients

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Background. Decreased coronary flow reserve (CFR) is a marker of endothelial dysfunction, coronary artery calcification and inflammation, well-known cardiovascular risk factors in haemodialysis (HD) patients. In this study, we aimed to investigate the correlation of coronary artery calcification scores (CACS) with CFR in HD patients.

Methods. Sixty-four end-stage renal failure patients were enrolled in this study (38 males, 26 females). Thirty-nine healthy subjects (22 males, 17 females) were included in the control group. Biochemical parameters and acute-phase inflammation marker [high-sensitivity C-reactive protein (hs-CRP)] of patients were recorded before dialysis. The CACS were measured by electron beam computerized tomography method. CFR recordings were performed by trans-thoracic Doppler echocardiography. The relationship between CACS and CFR was evaluated.

Results. The mean CACS was 281 ± 589 and 29 patients had CACS < 10. Patients with CACS > 10 had significantly lower CFR values compared to patients with CACS < 10 (1.56 ± 0.38 vs 1.84 ± 0.53, P = 0.024). However, there was no difference in hs-CRP values between the groups. CFR was negatively correlated with CACS (r = −0.276, P = 0.030). In multiple stepwise regression analysis, CACS was found to be an independent variable for predicting CFR (P = 0.048). During a follow-up of 18 months, 10 patients had experience of cardiovascular events. Patients with CACS > 10 had significantly higher event rate [34.5% (10/29) vs 0% (0/24)] compared to those with CACS < 10 (P = 0.001). Patients who developed cardiovascular events had significantly higher mean CACS and lower CFR values than the remaining group (P = 0.019 and P = 0.039). All of four patients who died during follow-up were in the CFR < 2 and CACS > 10 groups.

Conclusions. CACS was associated with CFR in HD patients. However, we did not find any association of inflammation with CACS and CFR. This association between CFR and CACS might indicate two different (anatomical and functional) aspects of the common pathophysiology of the arterial system in HD patients.

Keywords: coronary artery disease; coronary flow reserve; electron beam computed tomography; haemodialysis; vascular calcification

Journal Article.  4379 words.  Illustrated.

Subjects: Nephrology

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