title: Progression of coronary artery calcification and thoracic aorta calcification in kidney transplant recipients.
abstract: BACKGROUND
  Vascular calcification independently predicts cardiovascular disease, the major cause of death in kidney transplant recipients (KTRs). Longitudinal studies of vascular calcification in KTRs are few and small and have short follow-up. We assessed the evolution of coronary artery (CAC) and thoracic aorta calcification and their determinants in a cohort of prevalent KTRs.
  
  
  METHODS
  Longitudinal.
  
  
  METHODS
  The Agatston score of coronary arteries and thoracic aorta was measured by 16-slice spiral computed tomography in 281 KTRs.
  
  
  METHODS
  Demographic, clinical, and biochemical parameters were recorded simultaneously.
  
  
  METHODS
  The Agatston score was measured again 3.5 or more years later.
  
  
  RESULTS
  Repeated analyzable computed tomographic scans were available for 197 (70%) KTRs after 4.40 ± 0.28 years; they were not available for the rest of patients because of death (n = 40), atrial fibrillation (n = 1), other arrhythmias (n = 4), refusal (n = 35), or technical problems precluding confident calcium scoring (n = 4). CAC and aorta calcification scores increased significantly (by a median of 11% and 4% per year, respectively) during follow-up. By multivariable linear regression, higher baseline CAC score, history of cardiovascular event, use of a statin, and lower 25-hydroxyvitamin D(3) level were independent determinants of CAC progression. Independent determinants of aorta calcification progression were higher baseline aorta calcification score, higher pulse pressure, use of a statin, older age, higher serum phosphate level, use of aspirin, and male sex. Significant regression of CAC or aorta calcification was not observed in this cohort.
  
  
  CONCLUSIONS
  Cohort of prevalent KTRs with potential survival bias; few patients with diabetes and nonwhites, limiting the generalizability of results.
  
  
  CONCLUSIONS
  In contrast to previous small short-term studies, we show that vascular calcification progression is substantial within 4 years in prevalent KTRs and is associated with several traditional and nontraditional cardiovascular risk factors, some of which are modifiable.
authors.affiliation: Division of Nephrology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain Medical School, Brussels, Belgium.
authors.forename: Céline
authors.initials: C
authors.lastname: Maréchal
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coche
authors.forename: Eric
authors.initials: E
authors.lastname: Goffin
authors.forename: Anca
authors.initials: A
authors.lastname: Dragean
authors.forename: Georg
authors.initials: G
authors.lastname: Schlieper
authors.forename: Pauline
authors.initials: P
authors.lastname: Nguyen
authors.forename: Jürgen
authors.initials: J
authors.lastname: Floege
authors.forename: Nada
authors.initials: N
authors.lastname: Kanaan
authors.forename: Olivier
authors.initials: O
authors.lastname: Devuyst
authors.forename: Michel
authors.initials: M
authors.lastname: Jadoul
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology*; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D036542:Tomography, Spiral Computed