Background and Objective: Coronary artery calcification is a risk marker of atherosclerosis. Recently, a large multicenter, prospective observational study showed the CAC density was inversely related to the occurrence of cardiac vascular events. The proposed hypothesis is that low density area is more prone to rupture due to large lipid core and a marker of plaque instability. However, high CAC density in 125 chronic hemodialysis patients was associated with increased mortality. Our aim was to determine CAC density in new dialysis patients, and the role of DM in the progression of CAC density.

Design, Setting, Participants, and Measurements: Ninety-eight initial dialysis patients were enrolled. CAC density was calculated by Agatson score divided by calcium volume score. CAC density progression was measured by the difference in score between CT/time. Sixty-seven study participants had repeat CAC measures at one year.

Results: The mean age of study participants was 50.1 ± 12.7 years. A third were women, and 64.7% were black. The baseline CAC density for DM group was 85.2 (interquartile range (IQR), 10.3-452) compared to 0(IQR, 0-90.3) for non-DM group was (P=0.01). Seventy percent of diabetes patients had progression of calcium density while forty one percent of nondiabetic patients had progression of calcium density score. (P=0.02). Hazard ratio for DM after adjust for age and smoke is 2.0 (1.05-72.6).

Conclusions: Our results indicate that DM is a risk factor for high calcium density of individuals new to dialysis patients and is a risk factor for progression of calcium density score. Increased calcium density in new dialysis patient is a risk factor for CAC progression, rather than a marker of plaque stabilization.


N. Roy: None. D. Yang: None. S. Rosas: Research Support; Self; Bayer US, Ironwood Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc.

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