The Risk Factors And Features Of Coronary Artery Calcification

Background and Objective : Coronary heart disease(CHD) is the main reason leading to sudden death of cardiac origin,the chronic artery calcification(CAC) is an important risk factor of atherosclerosis,thus the detection of CAC has positive predict value.Along with the dual-source CT(DSCT) applications in recent years, it is significant for the diagnosis of CHD by this noninvasive method.The early diagnosis and treatment of CAC can reduce the incidence and mortality rates of cardiovascular events in CKD.We retrospectively collected the DSCT data of the hospitalized patients who were suspected of CHD, and their clinical materials were collected meanwhile in order to explore the risk factors associated with coronary calcification and observe the features of coronary artery calcification especially in the patients with chronic renal insufficiency meanwhile analyze the possible reasons preliminarily.Method: It was a collection of a total of 401 cases(including 329 CAC patients and 72 without CAC as controls) who were suspected of CHD in Tianjin First Central Hospital from July 2013 to September 2013. By comparing the two sets of clinical data to explore the risk factors associated with coronary artery calcification.Calcification positive group patients undergo coronary calcification calcium score(CACS) based on the results of coronary CTA, using Spearman correlation analysis study the relationship between CACS and related factors.Using Gensini scores to assess the coronary artery stenosis of partial patients accept the CAG examination and to explore the relationship with Gensini scores and CACS. To observe the characteristics of coronary artery calcification in particular the characteristics of coronary calcification in patients with renal insufficiency according to the results of coronary CTA,then try to explore the possible reasons.Results: 1. Calcification positive and negative group were significantly different in proportion of smoking history, prevalence of hypertension, diabetes and dyslipidemia; 2. The logistic analysis showed that age and phosphorus level can predict the incidence of coronary calcification well; 3. The Spearman correlation analysis showed that CACS were positively associated with age, phosphorus levels and calcium-phosphorus product while negatively correlated with GFR levels; 4. The coronary calcification trends to occur in the LAD; 5. Comparing the two groups we can find that more people in the CRI group have target calcified vessels with stenosis meanwhile and multivessel calcification than in the non-CRI group, the end stage group of CKD has significant higher levels of serum creatinine, phosphorus, calcium-phosphorus product and lower GFR levels than the non-CRI group and 3-4 stage group; 6. The patients who have target calcified vessels with stenosis contemporary have significant higher proportion of smoking history, LDL-C and TC levels than the other group; 7. CACS were positively associated with Gensini scores in the patients undergoing CAG.Conclusion: Age, hypertension, diabetes, smoking and dyslipidemia were risk factors for CAC, age and phosphorus are predictors of CAC,.CACS were associated with age, phosphorus, calcium-phosphorus product and GFR; The coronary calcification trends to occur in the LAD, target calcified vessels were often discovered with stenosis at the same time and comparing with the normal renal function patients calcified lesions were more complex in patients with renal insufficiency.