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Coronary artery calcium burden and coronary CT angiography evaluability in patients undergoing hemodialysis

Year: 2026

Type: preprint

Abstract: Purpose To investigate the association between coronary artery calcium (CAC) burden and coronary computed tomography angiography (CCTA) evaluability in patients undergoing maintenance hemodialysis. Methods This retrospective single-center study included 65 patients who underwent CAC scoring and CCTA. The right coronary artery, left anterior descending artery, and left circumflex artery were independently assessed by two blinded observers using a four-point image-quality scale. Arteries scored 3 or 4 were considered evaluable, and limited evaluability was defined as at least one non-evaluable major coronary artery. Associations were assessed using Spearman correlation, established CAC-score categories, receiver operating characteristic analysis with bootstrap confidence intervals, and multivariable logistic regression. Results The median total CAC score was 671 (interquartile range, 251–1,774). All three major coronary arteries were evaluable in 26 patients (40.0%), whereas 39 (60.0%) had limited evaluability. Median CAC scores increased stepwise as the number of evaluable arteries decreased from three to zero (162.5, 677.0, 1,663.0, and 2,180.0; Spearman’s ρ = −0.608, P < 0.001). CAC score ≥ 400 was associated with limited evaluability (odds ratio, 6.30; 95% CI, 2.10–18.90; P < 0.001). The AUC was 0.831 (bootstrap 95% CI, 0.723–0.925). After adjustment for age and sex, each approximate doubling of CAC score was associated with higher odds of limited evaluability (adjusted odds ratio, 2.01; 95% CI, 1.40–2.88; P < 0.001). Conclusion Increasing CAC burden was associated with a progressive reduction in CCTA evaluability in patients undergoing hemodialysis. CAC scoring may help anticipate technical limitations of CCTA and inform coronary imaging strategy.

Source: Research Square

DOI: 10.21203/rs.3.rs-10977067/v1

Authors: Takanori Masuda, Takeshi Nakaura, Yoshinori Funama, Takayuki Oku, Tomokazu Okimoto

Institutions: Kawasaki University of Medical Welfare, Kumamoto University, Tsuchiya General Hospital, Edogawa Hospital

Language: English

Topic: Cardiac Imaging and Diagnostics

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W7213752190

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