Abstract 15424: The Predictive Value of Abdominal Aortic Calcification on a Plain X-Ray For the Presence of Significant Coronary Artery Stenosis in Asymptomatic Dialysis Patients
Background Coronary artery disease (CAD) is common in asymptomatic chronic dialysis patients and plays an important role in their poor survival. Early identification of these high risk patients could improve intervention and mortality. Abdominal aortic calcification (AAC), which can be quantified using a lateral abdominal X-ray, has been associated with CAD in autopsy studies and with mortality and morbidity in dialysis patients. We hypothesized that the extent of AAC as assessed on a plain abdominal X-ray might be predictive of the presence of significant CAD in dialysis patients.
Methods All patients currently enrolled in the ICD2 trial (ISRCTN20479861) without a history of CABG or a PCI with stent were included in this study. All patients underwent CT-angiography (CTA) and a lateral X-ray of the abdomen. AAC on X-ray was quantified using a previously validated scoring system. The relation between AAC and the presence of CAD was subsequently assessed.
Results A total of 62 patients were included in this study (66% male, 67 ± 8 years old). Twenty-seven patients (44%) were found to have significant CAD following CTA. AAC-score was significantly higher in patients with CAD; 10.4 ± 5.5 vs 5.7 ± 4.1 (p<0.05). AAC-score is an independent predictor for the presence of CAD with a 1,2 fold higher risk per point increase (p=0.007) (Table). The AAC-score has a sensitivity of 78% and a specificity of 66% for predicting the presence of significant CAD.
Conclusion This study shows that abdominal aortic calcification as assessed on a lateral abdominal X-ray is predictive for the presence of significant coronary artery disease in asymptomatic dialysis patients. This simple, non-invasive and cheap screening method could contribute to early identification of patients eligible for further screening for CAD.
- © 2012 by American Heart Association, Inc.