Coronary Artery Calcification Progression Is Associated with Arterial Stiffness and Cardiac Repolarization Deterioration in Hemodialysis Patients

Background/Aims: Evidence suggests that vascular calcification (VC) portends poor cardiovascular (CV) prognosis in patients undergoing maintenance dialysis (CKD-5). Nonetheless, how VC might predispose to CV mortality still remains to be clarified. Herein, we report on the association between coronary artery calcification (CAC) progression and changes in cardiac repolarization as well as arterial stiffness. Methods: 132 patients new to dialysis were identified. Demographic and clinical characteristics were collected at study entry and during the 12-month follow-up. CAC, 12-lead ECG and pulse wave velocity (PWV) were assessed at baseline and study completion. Uni- and multivariable analyses were applied to detect factors associated with worsening of cardiac repolarization (QTd) and arterial stiffness (PWV). Results: Uni- and multivariable analyses revealed that CAC progression was associated with a significant increase in both QTd and PWV. Every 20-unit increase in the CAC score corresponded to a significant 23% (95% CI 1.12–1.27; p < 0.001) and 32% (95% CI 1.09–1.37; p < 0.01) increase in the risk of experiencing a 1-m/s increase in PWV and 1 ms in QTd, respectively. Conclusion: VC is a marker of vasculopathy and appears to be associated with cardiac repolarization and arterial stiffness abnormalities in CKD-5 patients.