title: Coronary Artery Calcium Score and Association with Recurrent Nephrolithiasis: The Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  Subclinical coronary artery calcification is an established predictor of cardiovascular events. While a history of kidney stones has been linked to subclinical carotid atherosclerosis, to our knowledge no study has examined its relationship with coronary artery calcification. We studied the association between kidney stone history and prevalent coronary artery calcification in MESA (Multi-Ethnic Study of Atherosclerosis).
  
  
  METHODS
  MESA is a multisite cohort study of participants 45 to 84 years old without known cardiovascular disease at baseline from 2000 to 2002. Computerized tomography was done in 3,282 participants at followup in 2010 to 2012 to determine coronary artery calcification and kidney stone history was assessed by self-report. Coronary artery calcification scores were categorized as none-0, mild-1 to 99, moderate-100 to 399 or severe-400 or greater. Cross-sectional analysis was performed adjusting for demographic and dietary factors related to kidney stones.
  
  
  RESULTS
  The prevalence of kidney stone disease history was approximately 9%, mean ± SD participant age was 69.5 ± 9.3 years, 39% of participants were Caucasian, 47% were men and 69% had detectable coronary artery calcification (score greater than 0). No difference in the score was seen between single stone formers and nonstone formers. Recurrent kidney stone formation was associated with moderate or severe calcification on multivariable logistic regression vs none or mild calcification (OR 1.80, 95% CI 1.22-2.67). When coronary artery calcification scores were separated into none, mild, moderate and severe calcification, recurrent stone formation was associated with a higher score category on multivariable ordinal logistic regression (OR 1.44 per category, 95% CI 1.04-2.01).
  
  
  CONCLUSIONS
  Recurrent kidney stone formation is associated with subclinical coronary atherosclerosis. This association appeared stronger with coronary artery calcification severity than with coronary artery calcification presence.
authors.affiliation: Department of Urology, School of Medicine, University of Washington, Seattle, Washington. Electronic address: rshsi@uw.edu.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Hsi
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Spieker
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco.
authors.forename: Marshall L
authors.initials: ML
authors.lastname: Stoller
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, Washington; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Alex P
authors.initials: AP
authors.lastname: Reiner
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.affiliation: Buck Institute for Research on Aging, Novato, California.
authors.forename: Arnold J
authors.initials: AJ
authors.lastname: Kahn
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco.
authors.forename: Thomas
authors.initials: T
authors.lastname: Chi
authors.affiliation: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.affiliation: Department of Urology, School of Medicine, University of Washington, Seattle, Washington; Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington; Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington.
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Sorensen
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D050197:Atherosclerosis / Q000150:complications* / Q000453:epidemiology*; D002118:Calcium / Q000032:analysis*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications* / Q000453:epidemiology*; D003331:Coronary Vessels / Q000737:chemistry*; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007669:Kidney Calculi / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D061205:Vascular Calcification / Q000150:complications* / Q000453:epidemiology*; D044465:White People
chemical_list: D002118:Calcium
keywords: arteriosclerosis; coronary artery disease; kidney; recurrence; urolithiasis