Coronary artery calcification and coronary ischaemia in renal transplant recipients.
BACKGROUND
Cardiovascular disease is the leading cause of mortality among renal transplant recipients. Data on the relationship between coronary artery calcification (CAC) and coronary ischaemia in renal transplantation patients are scant. We conducted a study to determine the prevalence and determinants of CAC in these patients; we also examined the frequency of coronary ischaemia in patients with moderate and severe CAC.


METHODS
We used multi-detector spiral computed tomography to examine CAC in 178 consecutive renal transplant recipients. Angina pectoris was sought with the Rose questionnaire. The extent of calcification was measured by Agatston score. Myocardial perfusion scintigraphy was performed in patients with moderate and severe CAC. Multivariate logistic and linear regression analysis was used to evaluate the determinants of CAC presence and CAC score, respectively.


RESULTS
CAC was present in 72 patients (40.4%), mean CAC score was 113.7±275.5 (median: 0 and range: 0-1712). Age, time on transplantation and Rose angina pectoris were the independent determinants of both CAC presence and high CAC scores in all multivariate models. Coronary ischaemia was detected in 17.1% of the patients with moderate-to-severe CAC.


CONCLUSIONS
CAC is highly prevalent in renal transplant recipients; it is associated with symptoms of coronary ischaemia. Time on transplantation is an independent determinant of CAC. Future studies to evaluate the prognostic significance of CAC in these patients are necessary.
Seyahi
Nurhan
N
Department of Internal Medicine, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. nseyahi@yahoo.com
Kahveci
Arzu
A
Cebi
Deniz
D
Altiparmak
Mehmet R
MR
Akman
Canan
C
Uslu
Ilhami
I
Ataman
Rezzan
R
Tasci
Hasan
H
Serdengecti
Kamil
K
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D014057:Tomography, X-Ray Computed