INTRODUCTION: An echocardiographic calcium score (ECS) predicts cardiovascular disease (CVD) in the general population. Its utility in peritoneal dialysis (PD) patients is unknown. METHODS: This cross-sectional study assessed 125 patients on PD. The ECS (range 0-8) was compared between subjects with CVD and those without. RESULTS: Among the subjects, 54 had CVD and 71 did not. Subjects with CVD were older (69 years vs. 56 years, P < 0.001) and had a higher prevalence of diabetes mellitus (DM) (81.5% vs. 45.1%, P < 0.001). They had lower diastolic blood pressure (72 mmHg vs. 81 mmHg, P < 0.001), lower phosphate (1.6 mmol/L vs. 1.9 mmol/L, P = 0.002), albumin (30 g/L vs. 32 g/L, P = 0.001), parathyroid hormone (34.4 pmol/L vs. 55.8 pmol/L, P = 0.002), total cholesterol (4.5 vs. 4.9, P = 0.047), LDL cholesterol (2.4 mmol/L vs. 2.8 mmol/L, P = 0.019) and HDL cholesterol (0.8 mmol/L vs. 1.1 mmol/L, P = 0.002). The ECS was found to be higher in subjects with CVD than in those without (2 vs. 1, P = 0.001). On multivariate analysis, only DM and age were independently associated with CVD. CONCLUSION The ECS was significantly higher in PD patients with CVD than in those without, reflecting a higher vascular calcification burden in the former. It is a potentially useful tool to quantify vascular calcification in PD patients.
Humans ; Cardiovascular Diseases/diagnostic imaging* ; Cross-Sectional Studies ; Calcium ; Peritoneal Dialysis/adverse effects* ; Vascular Calcification/epidemiology* ; Echocardiography

OBJECTIVE: To access application value of multi-slice spiral computed tomography (MSCT) and coronary artery calcium scoring (CACS) in investigation the coronary artery disease (CAD), and to explore the effective way of virtual autopsy to evaluate the sudden death due to CAD. METHODS: Nine cases of sudden cardiac death were collected to analyze MSCT before the autopsy. The quantitative analysis of the degree of coronary artery calcium was made by Agatston's method. The CACS of all the subjects were calculated based on the diagnostic criteria for CAD, in which calcium scoring was more than 400. The results of CACS were compared with that of the autopsy. RESULTS: Only 2 cases got the high calcium scoring which were more than 400 in the 9 cases died of CAD confirmed by the autopsy. The prediction rate of CACS for CAD was only 22.2%. Pulmonary edema of different severity was found in both autopsy and MSCT. There was a higher morbidity rate in the left anterior descending of coronary artery than the other branches. CONCLUSION Obvious calcification of coronary artery can be detected by MSCT and calculating CACS. To detect subtle calcification needs other technologies such as postmortem angiography.
Autopsy ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging* ; Death, Sudden/pathology* ; Humans ; Multidetector Computed Tomography/methods* ; Predictive Value of Tests ; Vascular Calcification/diagnostic imaging*

INTRODUCTIONIn Singapore, the age-standardised event rates of myocardial infarction (MI) are 2- and 3-fold higher for Malays and Indians respectively compared to the Chinese. The objectives of this study were to determine the prevalence and quantity of coronary artery calcification (CAC) and non-calcified plaques across these 3 ethnic groups.

MATERIALS AND METHODSThis was a retrospective descriptive study. We identified 1041 patients (810 Chinese, 139 Malays, 92 Indians) without previous history of cardiovascular disease who underwent cardiac computed tomography for atypical chest pain evaluation. A cardiologist, who was blinded to the patients' clinical demographics, reviewed all scans. We retrospectively analysed all their case records.

RESULTSOverall, Malays were most likely to be active smokers (P = 0.02), Indians had the highest prevalence of diabetes mellitus (P = 0.01) and Chinese had the highest mean age (P <0.0001). The overall prevalence of patients with non-calcified plaques as the only manifestation of sub-clinical coronary artery disease was 2.1%. There was no significant difference in the prevalence of CAC, mean CAC score or prevalence of non-calcified plaques among the 3 ethnic groups. Active smoking, age and hypertension were independent predictors of CAC. Non-calcified plaques were positively associated with male gender, age, dyslipidaemia and diabetes mellitus.

CONCLUSIONThe higher MI rates in Malays and Indians in Singapore cannot be explained by any difference in CAC or non-calcified plaque. More research with prospective follow-up of larger patient populations is necessary to establish if ethnic-specific calibration of CAC measures is needed to adjust for differences among ethnic groups.

Adult ; Age Distribution ; Aged ; Analysis of Variance ; Asian Continental Ancestry Group ; statistics & numerical data ; Case-Control Studies ; China ; ethnology ; Coronary Artery Disease ; diagnostic imaging ; ethnology ; Coronary Vessels ; diagnostic imaging ; Diabetes Mellitus ; ethnology ; Dyslipidemias ; ethnology ; European Continental Ancestry Group ; statistics & numerical data ; Female ; Humans ; Hypertension ; ethnology ; India ; ethnology ; Malaysia ; ethnology ; Male ; Middle Aged ; Plaque, Atherosclerotic ; diagnostic imaging ; ethnology ; Prevalence ; Retrospective Studies ; Sex Distribution ; Singapore ; epidemiology ; ethnology ; Smoking ; ethnology ; Tomography, X-Ray Computed ; Vascular Calcification ; diagnostic imaging ; ethnology