Abstract 14856: Serum Phosphate Level is a Predictive Marker for Aortic Calcification in Patients Without End-stage Renal Disease
Introduction: Vascular calcification (VC), commonly related to renal failure, diabetes, hypertension, and aging, is closely associated with cardiovascular events and mortality. High serum calcium and phosphate levels are well-known risk factors for VC in hemodialysis patients with end-stage renal disease (ESRD). However, their association with VC in those without ESRD is unclear. We aimed to assess the ability of serum calcium and phosphate levels to predict the aortic calcification severity in patients without ESRD.
Methods: Between January 2011 and December 2013, thoracoabdominal non-contrast-enhanced computed tomography was performed for 134 patients who were scheduled to undergo cardiac surgery as a general preoperative evaluation. Three patients receiving hemodialysis and 5 patients with a history of aortic surgery were excluded. The total aortic calcium volume (TAC-V) was quantified using the volume rendering method, by extracting the area with attenuation values of >130 HU within the aorta from just above the left main trunk to the aortic bifurcation. The TAC-V divided by body surface area was defined as the TAC-V index. Dense TAC-V (area with attenuation values of >400 HU) in the TAC-V was also quantified.
Results: In the 126 patients (age, 65.0 ± 12.8 years; 37% female), the median TAC-V index was 1.29 mL/m2 (range, 0-34.42 mL/m2). The mean estimated glomerular filtration rate, serum calcium, and serum phosphate levels were 63.9 ± 19.8 mL/min/1.73 m2, 9.1 ± 0.5 mg/dL, and 3.5 ± 0.6 mg/dL respectively. The mean serum phosphate level was significantly higher in high TAC-V (>3.34 mL/m2) than in low TAC-V (<3.34 mL/m2) group (3.7 ± 0.5 vs 3.5 ± 0.6 mg/dL; P <0.05), whereas the serum calcium level did not differ between the groups (9.2 ± 0.5 vs 9.1 ± 0.5 mg/dL; P = 0.66). In multivariate analysis, serum phosphate level (β = 1.76, P <0.05), age (β = 0.14, P <0.001), and hypertension (β = 0.93, P <0.05) were independent predictors of the high TAC-V index. Moreover, the serum phosphate level was significantly related to the dense TAC-V/TAC-V ratio (β = 0.04, P <0.05).
Conclusion: Serum phosphate level was significantly associated with aortic calcification even in patients without ESRD, and may be a new predictor of VC progression.
Author Disclosures: M. Kinugasa: None. T. Takaya: None. S. Mori: None. A. Kasamatsu: None. K. Kashio: None. T. Ito: None. S. Takamine: None. S. Satomi-Kobayashi: None. S. Fujiwara: None. T. Nishii: None. A.K. Kono: None. K. Hirata: None.
- © 2014 by American Heart Association, Inc.