title: Cardiac valve calcification is associated with presence and severity of coronary artery disease in patients with pre-dialysis chronic kidney disease.
abstract: BACKGROUND
  Cardiac valve calcification is common in chronic kidney disease (CKD) patients. Coronary artery disease (CAD) is the one of major causes for increased cardiovascular mortality in CKD patients. We hypothesized that cardiac valve calcification is associated with the presence and the severity of CAD in pre-dialysis CKD patients.
  
  
  METHODS
  This study included 1166 patients who underwent transthoracic echocardiography for assessment of cardiac valve calcification and coronary angiography for assessment of CAD. The patients were divided into two groups according to estimated glomerular filtration rate (eGFR): pre-dialysis CKD group (n = 215, eGFR < 60 ml/min/1.73 m(2)) and non-CKD group (n = 951, eGFR ≥ 60 ml/min/1.73 m(2)).
  
  
  RESULTS
  In the pre-dialysis CKD group, subjects with aortic valve calcification (AVC), mitral valve calcification (MVC), and at least one valve calcification had more severe CAD compared with those without AVC, MVC, and any valve calcification. Multivariate analysis showed that pre-dialysis CKD patients who had AVC, MVC, and at least one valve calcification were 3.02 times (P = 0.033), 3.73 times (P = 0.029), and 3.31 times (P = 0.012) more likely to have CAD compared with those without AVC, MVC, and any valve calcification, respectively. However, in the non-CKD group, there was no association between cardiac valve calcification and the severity/presence of CAD.
  
  
  CONCLUSIONS
  Cardiac valve calcification is associated with the presence and severity of CAD in pre-dialysis CKD. Assessment of cardiac valve calcification by means of transthoracic echocardiography could be a valuable non-invasive method for CAD risk stratification in pre-dialysis CKD patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Il Young
authors.initials: IY
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea. sbleemd@pusan.ac.kr.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea. sbleemd@pusan.ac.kr.
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Shin
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Harin
authors.initials: H
authors.lastname: Rhee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Byeong Yun
authors.initials: BY
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Seong
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography
keywords: Cardiac valve calcification; Chronic kidney disease; Coronary artery disease