Evidence map›Paper›PMID 34136785›Full record

ArticleKidney medicine

Coronary Artery Calcification as a Marker for Coronary Artery Stenosis: Comparing Kidney Failure to the General Population.

Thijs T Jansz, Meike H Y Go, Nolan S Hartkamp, J Lauran Stöger, Csilla Celeng, Tim Leiner, Pim A de Jong, Frank J L Visseren, Marianne C Verhaar, Brigit C van Jaarsveld

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Thijs T JanszDepartments of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht.
Meike H Y GoDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht.
Nolan S HartkampDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht.
J Lauran StögerDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht.
Csilla CelengDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht.
Tim LeinerDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht.
Pim A de JongDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht.
Frank J L VisserenDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht.
Marianne C VerhaarDepartments of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht.
Brigit C van JaarsveldDepartment of Nephrology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, Amsterdam.
Utrecht University · NLUniversity Medical Center Utrecht · NLAmsterdam Neuroscience · NLAmsterdam University of Applied Sciences · NLLeiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

RATIONALE &

objectiveThe presence of calcified plaques in the coronary arteries is associated with cardiovascular mortality and is a hallmark of chronic kidney failure, but it is unclear whether this is associated with the same degree of coronary artery stenosis as in patients without kidney disease. We compared the relationship of coronary artery calcification (CAC) and stenosis between dialysis patients and patients without chronic kidney disease (CKD). STUDY

designObservational cohort study. SETTING &

participants127 dialysis patients and 447 patients without CKD with cardiovascular risk factors underwent cardiac computed tomography (CT), consisting of non-contrast-enhanced CT and CT angiography. CAC score and degree of coronary artery stenosis were assessed by independent readers. PREDICTOR: Dialysis treatment. OUTCOME: Association between calcification and stenosis. ANALYTICAL APPROACH: Logistic regression to determine the association between CAC score and the presence of stenosis in a matched cohort and, in the full cohort, testing for the interaction of dialysis status with this relationship.

results112 patients were matched from each cohort, totaling 224 patients, using propensity scores for dialysis, balancing numerous cardiovascular risk factors. Median CAC score was 210 (IQR, 19-859) in dialysis patients and 58 (IQR, 0-254) in patients without CKD; 35% of dialysis patients and 36% of patients without CKD had coronary artery stenosis ≥ 50%. Per each 100-unit higher CAC score, the matched dialysis cohort had significantly lower ORs for stenosis than the non-CKD cohort, 0.67 (95% CI, 0.52-0.83) for stenosis ≥ 50% and 0.75 (95% CI, 0.62-0.90) for stenosis ≥ 70%. LIMITATIONS: No comparison with the gold standard fractional flow reserve.

conclusionsDialysis patients have higher risk for coronary artery stenosis with higher CAC scores, but this risk is comparatively lower than in patients without CKD with similar CAC scores. In dialysis patients, a high CAC score can easily be found without significant stenosis. Our data enable "translation" of degree of calcification to the probability of coronary stenosis in dialysis patients.

Indexed as

Coronary calcificationcoronary stenosisend-stage kidney diseasehemodialysisischemic cardiac diseaseperitoneal dialysisrenal failure

Identifiers

PMID34136785
PMCPMC8178454
OpenAlexW3156778355

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.