P109: Progression of Aortic Arch Calcification After Kidney Transplant and its Importance in Predicting Cardiovascular Risk: Single-Center 2-Year Follow-Up Study

Abstract

Table 1 Mean values of CAVI.

Vascular calcification (VC) is linked to post-transplant cardiovascular events in the long term. We aimed to evaluate whether pretransplant chest X-ray based aortic arch calcification (AoAC) or pulse wave velocity measurement can better predict post- transplant cardiovascular or cerebrovascular events, and to assess the progression of calcification within 2 years.

Methods

Our single-center observational longitudinal study enrolled 40 kidney transplant recipients (KTR) without previous history of vascular events (no cardiovascular, cerebrovascular events, no peripheral artery disease). Two radiologists evaluated pretransplant and postransplant (after 2 years) AoAC on chest X-ray by using two different AoAC scales: AoAC grade evaluation [1] and AoAC score as suggested by Ogawa et al. in 2009 [2]. Cohen’s kappa coefficient was 0.75. The mismatching results were repeatedly reviewed and resulted in consensus. Carotid-femoral (cfPWV) and carotid-radial pulse wave velocity (crPWV) was measured using applanation tonometry and the PWV ratio (cfPWV/rPWV) was calculated. Patient clinical, biochemical data and cardio-vascular/cerebrovascular event rate were monitored within 2 years.

Results

During 2-year follow-up 5 patients experienced cardiovascular events, which were predicted by PWV ratio, but not related to AoAC. In 3 patients, we observed progression of AoAC, in others e AoAC was less evident or remained unchanged in 2-years follow-up. AoAC score [2] could better describe the extent of vascular calcification in KTR.

Conclusions

KTR without previous vascular events have quite low cardiovas-cular/ cerebrovascular event rate within 2-year follow-up, which are better predicted by pretransplant PWV ratio. AoAC postransplant regression is evident even when using simplified chest X- ray scales.