Serum S100A12 and Progression of Coronary Artery Calcification Over 4 Years in Hemodialysis Patients

Background/Aim: Vascular calcification is common and contributes to increased cardiovascular mortality in hemodialysis (HD) patients. In this prospective study, we aimed to investigate the associations of serum S100A12 in the presence of severe coronary artery calcification (CAC) and the progression of CAC in HD patients. Methods: Sixty maintenance HD patients and 30 controls were enrolled. Serum S100A12 levels were measured using ELISA. CAC scores (CACs) were measured twice at a 4-year interval using multislice spiral CT. The HD patients were classified as rapid progressors or slow progressors according to the change in the CACs across these 2 measurements (ΔCACs). Results: The incidences of rapid progression of CAC in patients with baseline CACs ≤10, CACs >10 and CACs >400 were 12.5, 40.0 and 64.3%, respectively. Both baseline and 4-year serum S100A12 levels were significantly higher in the rapid progressors than in the slow progressors (medians of 45.6 vs. 30.2 ng/ml, p < 0.001 and 62.3 vs. 39.4 ng/ml, p = 0.002, respectively). The serum S100A12 levels were significantly correlated with baseline CACs (r = 0.466, p < 0.001), 4-year CACs (r = 0.440, p < 0.001) and ΔCACs (r = 0.392, p < 0.001). Importantly, the ΔCACs were significantly correlated with ΔS100A12 levels (r = 0.396, p < 0.001). Logistic regression analysis revealed that the serum S100A12 level was as an independent determinant of the presence of severe CAC and that the increment in the serum S100A12 level was a factor that was significantly independently associated with the progression of CAC. Conclusions: Serum S100A12 levels were significantly associated with the presence of severe CAC, and the increment in serum S100A12 levels was an independent determinant of the progression of CAC.