title: Coronary artery calcification: a strong predictor of cardiovascular events in renal transplant recipients.
abstract: BACKGROUND
  Coronary artery calcification (CAC) independently predicts cardiovascular events (CVE) in the general population. Whether this applies to renal transplant recipients (RTR) is unknown. This prospective study assessed the prognostic impact of CAC on CVE in RTR.
  
  
  METHODS
  We followed up a published cohort of 281 prevalent RTR. At baseline, 16-slice chest spiral computerized tomography scan was performed and classical as well as CKD-related risk factors were recorded. Major CVE (MCVE) was defined as cardiovascular death, myocardial infarction, stroke or transient ischaemic attack. All CVE (ACVE) included MCVE and revascularizations. Prognostic factors were assessed by univariate and multivariate Cox regression.
  
  
  RESULTS
  During 2.3 ± 0.5 years of follow-up, 16 patients died from CV (n = 8) or non-CV causes (n = 8). Thirty-one RTR developed at least one CVE (first CVE cardiac in 15, peripheral in 12 and cerebrovascular in 4) for a total of 36 CVE. Thirty-month CV survival, MCVE-free survival and ACVE-free survival was 96.4, 93.9 and 87.9%, respectively. By multivariate analysis, the independent predictors of ACVE were CAC score (hazards ratios [HR] = 1.40 [1.12; 1.75] for a 2.72-fold increase in CAC, P < 0.003) and history of CVE (HR = 2.76 [1.21; 6.39], P < 0.02).
  
  
  CONCLUSIONS
  Our study shows for the first time that CAC is a strong independent predictor of CVE in RTR.
authors.affiliation: Nephrology, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium.
authors.forename: Pauline T H
authors.initials: PT
authors.lastname: Nguyen
authors.forename: Séverine
authors.initials: S
authors.lastname: Henrard
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coche
authors.forename: Eric
authors.initials: E
authors.lastname: Goffin
authors.forename: Olivier
authors.initials: O
authors.lastname: Devuyst
authors.forename: Michel
authors.initials: M
authors.lastname: Jadoul
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies