Korean Journal of Nephrology 2010;29(2):232-240.
Comparison of Vascular Calcification Scores on Plain Radiographs as Predictors of Coronary Artery Disease in Hemodialysis Patients
Jung Min Kim, M.D., Won Suk An, M.D., Ki Hyun Kim, M.D., Seong Eun Kim, M.D., Young Ki Son, M.D., Seuk Hee Chung, M.D., You Jeong Oh, M.D., Woo Jai Kim, M.D., Dong Kyun Kim, M.D. and Hyang Suk Bae, M.D.
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
원저 : 혈액투석 환자에서 관상동맥질환의 예측인자로서 단순방사선 촬영상 혈관 석회화 점수들간의 비교
김정민, 안원석, 김기현, 김성은, 손영기, 정석희, 오유정, 김우재, 김동균, 배숙향
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
Purpose : Vascular calcification (VC) scores on simple plain radiographic films are known to be associated with coronary artery disease (CAD) and mortality. The present study was designed to demonstrate a correlation between VC scores of the hands and pelvis, and feet and lateral lumbar spine on plain radiographs. In addition, we analyzed the usefulness of checking all the plain radiographs for assessment of pre-existing CAD. Methods : We recruited 61 hemodialysis (HD) patients from OO Dialysis Center. We checked the plain radiographic films of the feet, hands, pelvis, and lateral lumbar spine and evaluated VC scores with previously reported methods. We defined CAD based on myocardial scans, echocardiography, or coronary angiography. Results : Positive associations were found between the VC scores of the feet, VC scores of the hands and pelvis, scores of abdominal aortic calcifications (AACs), and CAD. Approximately 30% of patients who had CAD could be missed based on a single VC scoring method. Patients who showed any one finding among the AAC scores >5, VC scores of the pelvis and hands >3 or arterial media calcifications of the feet on plain radiographs had a high sensitivity (93.8%) and a high negative predictive value (96.3%) for the presence of CAD. Conclusion : Each VC score was highly inter-correlated. All three VC scoring methods on plain radiographic films are useful screening tests for the presence of CAD in HD patients.
Key Words: Vascular calcification, Coronary artery disease, Hemodialysis

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