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Michael Y. Henein - One of the best experts on this subject based on the ideXlab platform.

Matthew J Budoff - One of the best experts on this subject based on the ideXlab platform.

  • Coronary Artery Calcification.
    Global heart, 2016
    Co-Authors: Kazuhiro Osawa, Rine Nakanishi, Matthew J Budoff
    Abstract:

    Abstract Coronary Artery Calcification (CAC) is an established marker of subclinical atherosclerosis and an independent predictor of future Coronary heart disease in the asymptomatic primary prevention population, particularly in the intermediate risk cohort. CAC also helps in reclassifying those patients and their risk of cardiovascular events into higher or lower risk categories. MESA (Multi-Ethnic Study of Atherosclerosis) is a National Heart, Lung, and Blood Institute–sponsored population-based medical research study involving 6,814 men and women from 6 U.S. communities without a medical history of clinical cardiovascular disease. The evidence from this population cohort revealed that CAC scoring was independently predictive and highly effective at risk stratification of major adverse cardiac events. This review provides available data based on MESA. We focus on the utility of CAC for cardiovascular disease risk stratification of individuals, and we describe its diagnostic value in identifying patients at risk.

  • Long-Term Prognosis After Coronary Artery Calcification Testing in Asymptomatic Patients
    Annals of Internal Medicine, 2015
    Co-Authors: Leslee J. Shaw, Matthew J Budoff, Ashley E. Giambrone, Michael J. Blaha, Joseph T. Knapper, Daniel S. Berman, Naveen Bellam, Arshed A. Quyyumi, Tracy Q. Callister, James K. Min
    Abstract:

    Coronary Artery Calcification (CAC) scores are used to predict mortality, but more is known about the accuracy of short-term predictions than long-term predictions based on these scores. This cohor...

  • Coronary Artery Calcification and mortality in diabetic patients with proteinuria
    Kidney international, 2010
    Co-Authors: Yi Wen Chiu, Matthew J Budoff, Sharon G. Adler, Junichiro Takasu, Jamila Ashai, Rajnish Mehrotra
    Abstract:

    Vascular Calcification is one of the mechanisms mediating the higher mortality risk associated with the hyperphosphatemia of chronic kidney disease. Though common, and often severe in non-dialyzed proteinuric diabetics, there are no studies on the prognostic significance of Coronary Artery Calcification in early stage type 2 diabetic nephropathy. Here we determine this significance in 225 proteinuric diabetic patients (mean age 57 years, mean estimated glomerular filtration rate (eGFR) 52 ml/min per 1.73 m 2 and a median urine protein–creatinine ratio of 2.7). Coronary Artery Calcification, measured by electron beam computed tomography, was diagnosed in 86% of the patients, the severity of which correlated with older age, male gender, and white ethnicity. However, no association was found between eGFR, serum calcium, phosphorus, parathyroid hormone, or 25-hydroxy vitamin D. Over an average follow-up of 39 months, 54 patients died. A graded relationship between the severity of Calcification and all-cause mortality was consistently demonstrated on both univariate and multivariate analyses. Patients in the highest quartile of Calcification score had a 2.5-fold higher risk for death. Our results show the severity of Coronary Artery Calcification early in the course of chronic kidney disease is an independent predictor of all-cause mortality. Additional studies need to determine whether altering the natural history of Coronary Artery Calcification in early chronic kidney disease prolongs survival.

  • association of serum alkaline phosphatase with Coronary Artery Calcification in maintenance hemodialysis patients
    Clinical Journal of The American Society of Nephrology, 2009
    Co-Authors: Ronney Shantouf, Csaba P Kovesdy, Naser Ahmadi, Amanda Luna, Claudia Luna, Mehdi Rambod, Allen R Nissenson, Matthew J Budoff, Kamyar Kalantarzadeh
    Abstract:

    Background and objectives: Recent in vitro studies have shown a link between alkaline phosphatase and vascular Calcification in patients with chronic kidney disease (CKD). High serum levels of alkaline phosphatase are associated with increased death risk in epidemiologic studies of maintenance hemodialysis (MHD) patients. We hypothesized that Coronary Artery Calcification is independently associated with increased serum alkaline phosphatase levels in MHD patients. Design, setting, participants, & measurements: We examined the association of Coronary Artery Calcification score (CACS) and alkaline phosphatase in 137 randomly selected MHD patients for whom markers of malnutrition, inflammation, and bone and mineral disorders were also measured. Results: Serum alkaline phosphatase was the only measure with significant and robust association with CACS (P 120 IU/L was a robust predictor of higher CACS and was particularly associated with the likelihood of CACS >400 (multivariate odds ratio 5.0 95% confidence interval 1.6 to 16.3; P = 0.007). Serum alkaline phosphatase of approximately 85 IU/L seemed to be associated with the lowest likelihood of severe Coronary Artery Calcification, but in the lowest tertile of alkaline phosphatase, the CACS predictability was not statistically significant. Conclusions: An association between serum alkaline phosphatase level and CACS exists in MHD patients. Given the high burden of vascular Calcification in patients with CKD, examining potential therapeutic interventions to modulate the alkaline phosphatase pathway may be warranted.

  • Determinants of Coronary Artery Calcification in diabetics with and without nephropathy.
    Kidney international, 2004
    Co-Authors: Rajnish Mehrotra, Matthew J Budoff, Junichiro Takasu, Peter D. Christenson, Eli Ipp, Ajay Gupta, Keith C. Norris, Sharon G. Adler
    Abstract:

    Determinants of Coronary Artery Calcification in diabetics with and without nephropathy. Background In the general population, including those with diabetes mellitus, Coronary Artery Calcification (CAC) correlates with atherosclerotic plaque burden. On the other hand, accumulating evidence suggests that disordered mineral metabolism significantly contributes to the vascular Calcification in individuals with end-stage renal disease (ESRD). Methods In order to determine the relative contribution of accelerated atherosclerosis and disordered mineral metabolism to CAC in chronic kidney disease, a pilot study of 90 patients with type 2 diabetes mellitus was done [age, 40–65 years; normoalbuminuria, N = 30; diabetic nephropathy (DN), N = 60]. Results CAC was more prevalent and severe among individuals with DN compared to diabetic controls (odds ratio for prevalence 8.1, 95% CI 2.3–28.5; median scores, 66 vs. 4, P Conclusion This first such study of nondialyzed individuals with DN suggests that, unlike ESRD patients, the high CAC burden seen at earlier stages of diabetic chronic kidney disease is probably unrelated to disordered mineral metabolism. The relationship between the severity of hypertension and CAC burden provides a probable target for intervention in the predialysis phase of DN.

Alaattin Yildiz - One of the best experts on this subject based on the ideXlab platform.

  • QT dispersion predicts mortality and correlates with both Coronary Artery Calcification and atherosclerosis in hemodialysis patients
    International urology and nephrology, 2013
    Co-Authors: Murat Guney, Abdullah Ozkok, Yasar Caliskan, Hamdi Pusuroglu, Halil Yazici, Savas Tepe, Huseyin Oflaz, Alaattin Yildiz
    Abstract:

    Purpose QT dispersion (QTd) was shown to be an independent predictor of mortality in hemodialysis (HD) patients. It may be hypothesized that Coronary Artery Calcification is related to QTd in HD patients because widespread Calcification may also involve the cardiac conducting system in these patients. In this study, we aimed to investigate the relationships of corrected QTd (QTcd) with Coronary Artery Calcification score (CACS), carotid plaque score (CPS) and possible influence of these parameters on survival of HD patients.

  • Osteoprotegerin/RANKL Axis and Progression of Coronary Artery Calcification in Hemodialysis Patients
    Clinical Journal of The American Society of Nephrology, 2012
    Co-Authors: Abdullah Ozkok, Yasar Caliskan, Tamer Sakaci, Gaye Erten, Gonca Emel Karahan, Alper Ozel, Abdulkadir Unsal, Alaattin Yildiz
    Abstract:

    BACKGROUND AND OBJECTIVES: Vascular Calcification is associated with increased cardiovascular mortality in chronic hemodialysis patients. This prospective study investigated the relationship between serum osteoprotegerin, receptor activator of NF-κB ligand, inflammatory markers, and progression of Coronary Artery Calcification score. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Seventy-eight hemodialysis patients were enrolled. Serum IL-1β, IL-6, TNF-α, osteoprotegerin, receptor activator of NF-κB, fetuin A, and bone alkaline phosphatase were measured by ELISA. Coronary Artery Calcification score was measured two times with 1-year intervals, and patients were classified as progressive or nonprogressive. RESULTS: Baseline and first-year serum osteoprotegerin levels were significantly higher in the progressive than nonprogressive group (17.39±9.67 versus 12.90±6.59 pmol/L, P=0.02; 35.17±18.35 versus 24±11.65 pmol/L, P=0.002, respectively). The ratio of serum osteoprotegerin to receptor activator of NF-κB ligand at 1 year was significantly higher in the progressive group (0.26 [0.15-0.46] versus 0.18 [0.12-0.28], P=0.004). Serum osteoprotegerin levels were significantly correlated with Coronary Artery Calcification score at both baseline (r=0.36, P=0.001) and 1 year (r=0.36, P=0.001). Importantly, progression in Coronary Artery Calcification score significantly correlated with change in serum osteoprotegerin levels (r=0.39, P=0.001). In addition, serum receptor activator of NF-κB ligand levels were significantly inversely correlated with Coronary Artery Calcification scores at both baseline (r=-0.29, P=0.01) and 1 year (r=-0.29, P=0.001). In linear regression analysis for predicting Coronary Artery Calcification score progression, only baseline Coronary Artery Calcification score and change in osteoprotegerin were retained as significant factors in the model. CONCLUSIONS: Baseline Coronary Artery Calcification score and serum osteoprotegerin levels were significantly associated with progression of Coronary Artery Calcification score in hemodialysis patients.

  • Osteoprotegerin/RANKL Axis and Progression of Coronary Artery Calcification in Hemodialysis Patients
    Clinical journal of the American Society of Nephrology : CJASN, 2012
    Co-Authors: Abdullah Ozkok, Yasar Caliskan, Tamer Sakaci, Gaye Erten, Gonca Emel Karahan, Alper Ozel, Abdulkadir Unsal, Alaattin Yildiz
    Abstract:

    Summary Background and objectives Vascular Calcification is associated with increased cardiovascular mortality in chronic hemodialysis patients. This prospective study investigated the relationship between serum osteoprotegerin, receptor activator of NF-kB ligand, inflammatory markers, and progression of Coronary Artery Calcification score. Design, setting, participants, & measurements Seventy-eight hemodialysis patients were enrolled. Serum IL-1b, IL-6, TNF-a, osteoprotegerin, receptor activator of NF-kB, fetuin A, and bone alkaline phosphatase were measured by ELISA. Coronary Artery Calcification score was measured two times with 1-year intervals, and patients were classified as progressive or nonprogressive. Results Baseline and first-year serum osteoprotegerin levels were significantly higher in the progressive than nonprogressive group (17.3969.67 versus 12.9066.59 pmol/L, P=0.02; 35.17618.35 versus 24611.65 pmol/L, P=0.002, respectively). The ratio of serum osteoprotegerin to receptor activator of NF-kB ligand at 1 year was significantly higher in the progressive group (0.26 [0.15–0.46] versus 0.18 [0.12–0.28], P=0.004). Serum osteoprotegerin levels were significantly correlated with Coronary Artery Calcification score at both baseline (r=0.36, P=0.001)and1year(r=0.36,P=0.001).Importantly,progressioninCoronaryArteryCalcificationscoresignificantly correlatedwith changein serumosteoprotegerin levels (r=0.39,P=0.001). In addition, serumreceptor activator of NF-kB ligand levels were significantly inversely correlated with Coronary Artery Calcification scores at both baseline (r=20.29, P=0.01) and 1 year (r=20.29, P=0.001). In linear regression analysis for predicting Coronary Artery Calcification score progression, only baseline Coronary Artery Calcification score and change in osteoprotegerin were retained as significant factors in the model. Conclusions Baseline Coronary Artery Calcification score and serum osteoprotegerin levels were significantly associated with progression of Coronary Artery Calcification score in hemodialysis patients. Clin J Am Soc Nephrol 7: 965–973, 2012. doi: 10.2215/CJN.11191111

Rajnish Mehrotra - One of the best experts on this subject based on the ideXlab platform.

  • Coronary Artery Calcification and mortality in diabetic patients with proteinuria
    Kidney international, 2010
    Co-Authors: Yi Wen Chiu, Matthew J Budoff, Sharon G. Adler, Junichiro Takasu, Jamila Ashai, Rajnish Mehrotra
    Abstract:

    Vascular Calcification is one of the mechanisms mediating the higher mortality risk associated with the hyperphosphatemia of chronic kidney disease. Though common, and often severe in non-dialyzed proteinuric diabetics, there are no studies on the prognostic significance of Coronary Artery Calcification in early stage type 2 diabetic nephropathy. Here we determine this significance in 225 proteinuric diabetic patients (mean age 57 years, mean estimated glomerular filtration rate (eGFR) 52 ml/min per 1.73 m 2 and a median urine protein–creatinine ratio of 2.7). Coronary Artery Calcification, measured by electron beam computed tomography, was diagnosed in 86% of the patients, the severity of which correlated with older age, male gender, and white ethnicity. However, no association was found between eGFR, serum calcium, phosphorus, parathyroid hormone, or 25-hydroxy vitamin D. Over an average follow-up of 39 months, 54 patients died. A graded relationship between the severity of Calcification and all-cause mortality was consistently demonstrated on both univariate and multivariate analyses. Patients in the highest quartile of Calcification score had a 2.5-fold higher risk for death. Our results show the severity of Coronary Artery Calcification early in the course of chronic kidney disease is an independent predictor of all-cause mortality. Additional studies need to determine whether altering the natural history of Coronary Artery Calcification in early chronic kidney disease prolongs survival.

  • Determinants of Coronary Artery Calcification in diabetics with and without nephropathy.
    Kidney international, 2004
    Co-Authors: Rajnish Mehrotra, Matthew J Budoff, Junichiro Takasu, Peter D. Christenson, Eli Ipp, Ajay Gupta, Keith C. Norris, Sharon G. Adler
    Abstract:

    Determinants of Coronary Artery Calcification in diabetics with and without nephropathy. Background In the general population, including those with diabetes mellitus, Coronary Artery Calcification (CAC) correlates with atherosclerotic plaque burden. On the other hand, accumulating evidence suggests that disordered mineral metabolism significantly contributes to the vascular Calcification in individuals with end-stage renal disease (ESRD). Methods In order to determine the relative contribution of accelerated atherosclerosis and disordered mineral metabolism to CAC in chronic kidney disease, a pilot study of 90 patients with type 2 diabetes mellitus was done [age, 40–65 years; normoalbuminuria, N = 30; diabetic nephropathy (DN), N = 60]. Results CAC was more prevalent and severe among individuals with DN compared to diabetic controls (odds ratio for prevalence 8.1, 95% CI 2.3–28.5; median scores, 66 vs. 4, P Conclusion This first such study of nondialyzed individuals with DN suggests that, unlike ESRD patients, the high CAC burden seen at earlier stages of diabetic chronic kidney disease is probably unrelated to disordered mineral metabolism. The relationship between the severity of hypertension and CAC burden provides a probable target for intervention in the predialysis phase of DN.

George Koulaouzidis - One of the best experts on this subject based on the ideXlab platform.