终末期肾脏病患者冠状动脉钙化评估方法与心血管事件的关系

目的:分析终末期肾脏病（ESRD）患者冠状动脉钙化（CAC）及其评估方法与主要心血管不良事件（MACE）的关系。方法:选取2018年5月至2020年10月在中山大学附属东华医院确诊为ESRD患者共228例，分析ESRD患者合并CAC的病例特点，并通过logistic回归法分析CAC评估方法CT重建技术中Agatston...

Assessment of coronary artery calcification and its relationship with cardiovascular events in patients with end-stage renal diseases

Objective　To analyze theassessment method of coronary artery calcification (CAC) in patients withend-stage renal diseases (ESRD) and its relationship with major adversecardiovascular events (MACE). Methods　From May 2018 to October 2020, 228 patients with ESRD from TungWahHospital of Sun Yat-sen University were enrolled. The clinical characteristicsof ESRD patients with CAC were analyzed. Logistic regression analysis was usedto evaluate the assessment and forecast the efficiencies of CAC integral [Agatston(AS) integral, volume integral (VS integral), and mass integral (MS integral)]in CT reconstruction technique for the occurrence of MACE in the ESRD patients.Independent sample t test was usedfor inter-group comparison of the measurement data conforming to normaldistribution, rank sum test was used for inter-group comparison of themeasurement data conforming to abnormal distribution, and χ² test was used for inter-group comparison of the countdata. Results　According to the occurrence of CAC, the ESRD patients were dividedinto a CAC group [164 cases, 108 males and 56 females, aged 61.00 (50.00,71.00) years] and a non-CAC group [64 cases, 43 males and 21 females, aged38.00 (31.00, 45.00) years]. The incidence of MACE in the CAC group was significantlyhigher than that in the non-CAC group [60.98% (100/164) vs. 21.87% (14/64)],with a statistically significant difference (P<0.001). In the CAC group, the three CAC integrals of the MACEsubgroup were significantly higher than those of the non-MACE subgroup (ASintegral: 4 267.0 vs. 725.3, P<0.001;MS integral: 3.2 vs. 2.7, P<0.001;VS integral: 4 732.0 vs. 881.9, P<0.001).Logistic regression analysis showed that AS integral, MS integral, VS integral,and albumin were all risk factors for MACE in the ESRD patients, among which MSintegral and albumin were independent risk factors for MACE in the ESRDpatients (all P<0.05). Conclusions　ESRD patients with CAC have a high incidence of MACE. MS integral isan independent risk factor of MACE occurrence in ESRD patients, and might beapplied to clinical monitoring of the occurrence and development of MACE inESRD patients.