Aortic calcification and contrast-associated acute kidney injury in patients undergoing urgent coronary angiography.

Aortic calcification detected on computed tomography (CT) is a marker of systemic atherosclerosis. Its clinical significance in predicting contrast-associated acute kidney injury (CA-AKI) after urgent coronary angiography remains unclear. A total of 140 patients (median age, 73 years [interquartile range 58-81]; female, 24.3%) were included. Calcification was assessed in the ascending aorta, aortic arch/descending aorta, abdominal aorta, coronary arteries, and renal arteries. The primary endpoint was CA-AKI, and the secondary endpoint was serial change in estimated glomerular filtration rate (eGFR) within 3 days after the procedure. CA-AKI occurred in 12.9% of patients. In univariate analysis, calcification of the aortic arch/descending aorta and abdominal aorta was associated with CA-AKI. Calcification of the ascending aorta was not associated with CA-AKI. After multivariable adjustment, calcification of the aortic arch/descending aorta remained associated with CA-AKI. Patients with calcification in these segments showed significantly attenuated improvement in eGFR over time. Among patients undergoing urgent coronary angiography, calcification of the aortic arch/descending aorta and abdominal aorta on CT was associated with CA-AKI and impaired short-term renal recovery. Aortic calcification may provide rapid preprocedural risk stratification.