Coronary Artery Calcium Score and Association with Recurrent Nephrolithiasis: The Multi-Ethnic Study of Atherosclerosis

Ryan S. Hsi, Andrew J. Spieker, Marshall L. Stoller, David R. Jacobs, Alex P. Reiner, Robyn L. McClelland, Arnold J. Kahn, Thomas Chi, Moyses Szklo, Mathew D. Sorensen

Subclinical coronary artery calcification (CAC) is an established predictor of cardiovascular events. While a history of kidney stones has been linked to subclinical carotid atherosclerosis, no study has examined its relationship with CAC. We studied the association between kidney stone history and prevalent CAC from the MESA study. The Multi-Ethnic Study of Atherosclerosis is a multi-site cohort study of participants aged 45-84 without known cardiovascular disease at baseline (2000-2002). At follow up in 2010-2012, 3,282 participants underwent computed tomography to determine CAC and had kidney stone history assessed by self-report. CAC scores were categorized as none, mild (<100), moderate (101-400), or severe (>400). A cross-sectional analysis was performed adjusting for demographic and dietary factors related to kidney stones. Prevalence of kidney stone disease history was approximately 9%, mean age was 69.5±9.3 years, 39% of participants were Caucasian, 47% were men, and 69% had detectable (CAC score >0). No difference in CAC score was seen between single stone formers and non-stone formers. Recurrent kidney stone formation was associated with moderate or severe CAC on multivariable logistic regression (versus none or mild CAC) (OR 1.80, 95% CI 1.22-2.67). When CAC scores were separated into none, mild, moderate, and severe CAC, recurrent stone formation was associated with higher CAC score category on multivariable ordinal logistic regression (OR per category 1.44, 95% CI 1.04- 2.01). Recurrent kidney stone formation is associated with subclinical coronary atherosclerosis. This association appeared stronger with CAC severity than with CAC presence.