Association Between Angiotensin‐Converting Enzyme 2 and Coronary Artery Calcification in Patients on Maintenance Hemodialysis Therapy

While all mechanisms that contribute to the pathogenesis of coronary artery calcification ( CAC ) are unknown, angiotensin‐converting enzyme 2 ( ACE 2) may be involved in this process in maintenance hemodialysis ( MHD ) patients. The aim of this study was to investigate the association between ACE 2 and CAC in patients on MHD therapy. Ninety patients on MHD therapy were involved in this prospective study. CAC was quantified by CAC score ( CACs ) using the A gatston method and a multi‐slice CT scanner. Univariate and multivariate logistic regression were used to analyze the association between ACE 2 and CACs . In the univariate analysis, CACs positively correlated with ACE 2 (r = 0.666, P  < 0.001). After adjusting for age, sex, smoking, hypertension, body mass index, diabetes mellitus, and hyperlipidemia, ACE 2 levels continued to significantly and independently predict the presence of CAC . ROC curve analysis showed that the serum ACE 2 level can predict the extent of CAC . These findings indicate that elevated serum ACE 2 may be involved in vascular calcification in patients receiving MHD therapy.