Journal Article

Coronary artery calcification and coronary ischaemia in renal transplant recipients

Nurhan Seyahi, Arzu Kahveci, Deniz Cebi, Mehmet R. Altiparmak, Canan Akman, Ilhami Uslu, Rezzan Ataman, Hasan Tasci and Kamil Serdengecti

in Nephrology Dialysis Transplantation

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

Volume 26, issue 2, pages 720-726
Published in print February 2011 | ISSN: 0931-0509
Published online July 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq413
Coronary artery calcification and coronary ischaemia in renal transplant recipients

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Background. Cardiovascular disease is the leading cause of mortality among renal transplant recipients. Data on the relationship between coronary artery calcification (CAC) and coronary ischaemia in renal transplantation patients are scant. We conducted a study to determine the prevalence and determinants of CAC in these patients; we also examined the frequency of coronary ischaemia in patients with moderate and severe CAC.

Methods. We used multi-detector spiral computed tomography to examine CAC in 178 consecutive renal transplant recipients. Angina pectoris was sought with the Rose questionnaire. The extent of calcification was measured by Agatston score. Myocardial perfusion scintigraphy was performed in patients with moderate and severe CAC. Multivariate logistic and linear regression analysis was used to evaluate the determinants of CAC presence and CAC score, respectively.

Results. CAC was present in 72 patients (40.4%), mean CAC score was 113.7 ± 275.5 (median: 0 and range: 0–1712). Age, time on transplantation and Rose angina pectoris were the independent determinants of both CAC presence and high CAC scores in all multivariate models. Coronary ischaemia was detected in 17.1% of the patients with moderate-to-severe CAC.

Conclusions. CAC is highly prevalent in renal transplant recipients; it is associated with symptoms of coronary ischaemia. Time on transplantation is an independent determinant of CAC. Future studies to evaluate the prognostic significance of CAC in these patients are necessary.

Keywords: cardiovascular disease; coronary artery disease; coronary calcification; transplantation; vascular calcification

Journal Article.  5025 words.  Illustrated.

Subjects: Nephrology

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