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The Agatston coronary artery calcification score (CACS) is utilized as an index to assess coronary artery calcification (CAC). The objective of this study was to investigate the characteristics of CACS in patients with end-stage kidney disease (ESKD) and establish a predictive model to evaluate the risk of severe CAC in these patients.
Patients with ESKD were enrolled in a study conducted from June 2017 to April 2022. The assessment of CACS was performed using chest computed tomography (CT) scans, employing the Agatston scoring method. Through the utilization of stepwise regression analysis, a predictive nomogram model was developed. Subsequently, an independent validation cohort consisting of patients with ESKD, encompassing the period from May 2022 to May 2023, was formed, inclusive of individuals from multiple centers.
In this study, a total of 369 patients with ESKD were included in the training set, while 127 patients were included in the validation set. Within the training set, the patients were categorized into three subgroups based on the extent of calcification: no calcification (CACS=0, n=98), mild calcification (0≤400, n=141), and severe calcification (CACS>400, n=130). Among the four coronary branches, the left anterior descending branch (LAD) exhibited the highest proportion of calcification(Fig 1).
Among the four branches of the coronary arteries, the most prevalent occurrence of calcification is found in the LAD artery. In order to ascertain the likelihood of severe coronary calcification in ESKD patients who are unable to undergo coronary CT analysis, we have created a nomogram model that has been validated using comprehensive clinical data.