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COMPLEMENTARY PROGNOSTIC VALUE OF RENAL FUNCTION AND CORONARY ARTERY CALCIUM SCORE IN PATIENTS WITHOUT KNOWN CORONARY ARTERY DISEASE: UP TO 5-YEAR FOLLOW-UP
A1135 JACC March 17, 2015 Volume 65, Issue 10S
Non Invasive Imaging (Echocardiography, Nuclear, PET, MR and CT) Complementary Prognostic Value of Renal Function and Coronary Artery Calcium Score in Patients Without Known Coronary Artery Disease: Up to 5-Year Follow-up Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: Non Invasive Imaging: CTA and CT Myocardial Perfusion Abstract Category: 16. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography Presentation Number: 1103-052 Authors: Kongkiat Chaikriangkrai, Alejandro Trevino, Naveed Anwar, Farshad Forouzandeh, Faisal Nabi, John Mahmarian, Su Min Chang, Houston Methodist Hospital, Houston, TX, USA Background: Long-term prognostic value of renal function and coronary artery calcium score (CACS) in symptomatic patients without known coronary artery disease (CAD) is unclear.
Methods: Renal function and CACS was assessed in patients without known CAD who presented with chest pain to our emergency room. Chronic kidney disease (CKD) was defined as eGFR < 60 mL/min/1.73 m2.
Results: A total of 949 patients (804 non-CKD and 145 CKD, age 54 ± 13 y, 40% male, 57% hypertensive, 15% diabetic, 34% dyslipidemic and 18% smokers) were included. During the follow up of up to 5.3 y (median=3.6 y), cardiac events occurred in 5.7% (19 cardiac deaths, 6 myocardial infarction, and 29 late revascularization). The event rates were higher in patients with higher CACS irrespective of CKD (figure). In multivariate analysis adjusted for Framingham score, both CACS (CACS 1-100 : HR 3.2; CACS 101-400 : HR 7.7, CACS>400: HR 8.9) and CKD (HR 10.2) were independently associated with events. Both adding CKD and CACS improved predictive performance (p<0.001 both). However; in patients with CACS=0, the event rates were not different between those with and without CKD (0.5%/y both groups; p=1.00). Conclusion: In our long-term cohort of patients without known CAD, both CACS and renal function are independent predictors for cardiac events. CKD provided incremental prognostic value over CACS and vice versa. However, in patients with CACS=0, presence of CKD was not significantly associated with increased risk for cardiac events.
Non Invasive Imaging (Echocardiography, Nuclear, PET, MR and CT) Complementary Prognostic Value of Renal Function and Coronary Artery Calcium Score in Patients Without Known Coronary Artery Disease: Up to 5-Year Follow-up Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: Non Invasive Imaging: CTA and CT Myocardial Perfusion Abstract Category: 16. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography Presentation Number: 1103-052 Authors: Kongkiat Chaikriangkrai, Alejandro Trevino, Naveed Anwar, Farshad Forouzandeh, Faisal Nabi, John Mahmarian, Su Min Chang, Houston Methodist Hospital, Houston, TX, USA Background: Long-term prognostic value of renal function and coronary artery calcium score (CACS) in symptomatic patients without known coronary artery disease (CAD) is unclear.
Methods: Renal function and CACS was assessed in patients without known CAD who presented with chest pain to our emergency room. Chronic kidney disease (CKD) was defined as eGFR < 60 mL/min/1.73 m2.
Results: A total of 949 patients (804 non-CKD and 145 CKD, age 54 ± 13 y, 40% male, 57% hypertensive, 15% diabetic, 34% dyslipidemic and 18% smokers) were included. During the follow up of up to 5.3 y (median=3.6 y), cardiac events occurred in 5.7% (19 cardiac deaths, 6 myocardial infarction, and 29 late revascularization). The event rates were higher in patients with higher CACS irrespective of CKD (figure). In multivariate analysis adjusted for Framingham score, both CACS (CACS 1-100 : HR 3.2; CACS 101-400 : HR 7.7, CACS>400: HR 8.9) and CKD (HR 10.2) were independently associated with events. Both adding CKD and CACS improved predictive performance (p<0.001 both). However; in patients with CACS=0, the event rates were not different between those with and without CKD (0.5%/y both groups; p=1.00). Conclusion: In our long-term cohort of patients without known CAD, both CACS and renal function are independent predictors for cardiac events. CKD provided incremental prognostic value over CACS and vice versa. However, in patients with CACS=0, presence of CKD was not significantly associated with increased risk for cardiac events.