Impact of serum calcium and phosphate on coronary atherosclerosis detected by cardiac computed tomography

High calcium (Ca), phosphate (P), and Ca-P product (CPP) are associated with cardiovascular disease in patients with chronic kidney disease. Whether this relationship persists in individuals with normal kidney function is not yet elucidated. We explored the relationship of serum Ca, P, and CPP to co...

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Published in:European heart journal 2012-11, Vol.33 (22), p.2873-2881
Main Authors: SHIN, Sanghoon, KIM, Kwang-Joon, HA, Jong-Won, JANG, Yangsoo, CHUNG, Namsik, CHANG, Hyuk-Jae, CHO, Iksung, YOUNG JIN KIM, CHOI, Byoung-Wook, RHEE, Yumie, LIM, Sung-Kil, YANG, Woo-In, SHIM, Chi-Young
Format: Article
Language:English
Subjects:
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Calcium - blood
Calcium Phosphates - blood
Cardiology. Vascular system
Coronary Angiography - methods
Coronary Artery Disease - blood
Coronary Artery Disease - diagnostic imaging
Coronary heart disease
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Multidetector Computed Tomography - methods
Phosphates - blood
Plaque, Atherosclerotic - blood
Plaque, Atherosclerotic - diagnostic imaging
Retrospective Studies
Vascular Calcification - blood
Vascular Calcification - diagnostic imaging
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Summary:High calcium (Ca), phosphate (P), and Ca-P product (CPP) are associated with cardiovascular disease in patients with chronic kidney disease. Whether this relationship persists in individuals with normal kidney function is not yet elucidated. We explored the relationship of serum Ca, P, and CPP to coronary atherosclerosis assessed by cardiac computed tomography angiography (cCTA) in participants with normal kidney function. This study included 7553 participants (52 ± 10 years, male 57%) with near-normal kidney function (estimated glomerular filtration rate > 60 mL/min/1.73 m2) who underwent cCTA. The relationship of Ca, P, and CPP to coronary atherosclerosis [coronary artery Ca score (CACS) >100 and the presence of coronary artery disease (CAD)] was evaluated. Higher Ca, P, and CPP were significantly associated with CACS > 100 continuously [adjusted odds ratio (OR) per mg/dL: Ca 1.21, P = 0.026; P 1.29, P < 0.001; CPP 1.03, P < 0.001]. However, they correlate only weakly with the presence of CAD (OR: Ca 1.17, P = 0.001; P 1.05, P = 0.173; CPP 1.01, P = 0.034). This discrepancy was because calcified or mixed plaque and non-calcified plaque (NCP) were included in CAD. A significant relationship was demonstrated between calcified or mixed plaque and Ca, P, and CPP (OR: Ca 1.20, P = 0.001; P 1.13, P = 0.003; CPP 1.02, P = 0.001), but not NCP. Elevated serum levels of Ca, P, and CPP are significantly associated with the presence of calcified coronary atherosclerotic plaque. It is unclear if there is a causal relationship. This relationship is thought to contribute to vascular calcification, but is less closely associated with NCP.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehs152