Serum phosphate is an independent predictor of the total aortic calcification volume in non-hemodialysis patients undergoing cardiovascular surgery

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• 作者：Mitsuo Kinugasa ; MD ; PhD^a ; ^b ; ¹ ; Shumpei Mori ; MD^a ; ¹ ; Tomofumi Takaya ; MD ; PhD^a ; ^{toto54@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Tatsuro Ito ; MD ; PhD^a ; Hidekazu Tanaka ; MD ; PhD ; FJCC^a ; Seimi Satomi-Kobayashi ; MD ; PhD^a ; Sei Fujiwara ; MD ; PhD^a ; Tatsuya Nishii ; MD ; PhD^c ; Atsushi K. Kono ; MD ; PhD^c ; Yutaka Okita ; MD ; PhD^d ; Ken-ichi Hirata ; MD ; PhD^a
• 关键词：Aortic calcification ; Vascular calcification ; Serum phosphate ; Computed tomography ; Non-hemodialysis patients
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：68
• 期：4
• 页码：308-315
• 全文大小：1087 K

文摘

A high serum phosphate level is a well-known risk factor for vascular calcification (VC) in patients on hemodialysis (HD). However, the association between the serum phosphate level and VC in non-HD patients is unclear. Our aim was to assess the impact of serum phosphate level on aortic calcification (AC) volume in non-HD patients undergoing cardiovascular surgery.

Methods

A total of 117 patients who underwent thoracoabdominal computed tomography as a preoperative general evaluation before cardiovascular surgery were enrolled. The total AC volume was quantified using the volume-rendering method by extracting the area ≥130 HU within the entire aorta. The total AC volume index (AC-VI) was estimated as the total AC volume divided by the body surface area.

Results

In the 117 patients (64.7 ± 13.1 years, 39% women), the median total AC-VI was 1.23 mL/m². The mean estimated glomerular filtration rate (eGFR), adjusted serum calcium levels, and serum phosphate levels were 63.8 ± 19.9 mL/min/1.73 m², 9.1 ± 0.4 mg/dL, and 3.6 ± 0.6 mg/dL, respectively. When the patients were classified into four quartiles based on their total AC-VI value, the serum phosphate level showed a positive correlation with a probability of being in the highest AC-VI quartile (R² = 0.0146, p = 0.0383) whereas the adjusted serum calcium level did not show a significant correlation (R² = 0.0040, p = 0.2615). A similar relationship between the serum phosphate level, adjusted serum calcium level, and AC-VI was confirmed when the total AC-VI was divided into the thoracic AC-VI and abdominal AC-VI. Multivariate analysis indicated that the serum phosphate level was an independent positive predictor of higher total AC-VI quartiles (β = 0.8013, p = 0.0160).

Conclusions

An increase in serum phosphate level was associated with an increased AC burden in non-HD patients undergoing cardiovascular surgery.