Impact of renal function on coronary plaque composition

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Medical Imaging

Background:

• Chronic kidney disease (CKD) significantly elevates atherosclerosis risk.
• Integrated backscatter intravascular ultrasound (IB-IVUS) enables coronary plaque component analysis.
• Lipid-rich plaques are linked to vulnerable plaque characteristics.

Purpose of the Study:

• To investigate the association between renal function and coronary plaque composition.
• To characterize plaque tissue at the target stenotic site before percutaneous coronary intervention (PCI).

Main Methods:

• Prospective study of 89 stable angina patients undergoing elective PCI.
• Coronary plaque tissue characterization using 3D IB-IVUS before PCI.
• Patients stratified into two groups based on estimated glomerular filtration rate (eGFR <60 vs. ≥60 ml/min/1.73 m²).

Main Results:

• Lower eGFR (<60 ml/min/1.73 m²) correlated with higher lipid volume (36.7% vs. 28.7%, P < 0.001).
• Lower eGFR correlated with lower fibrous volume (59.1% vs. 66.3%, P < 0.001).
• Significant negative correlation between eGFR and lipid volume (r = -0.44, P < 0.0001).
• Significant positive correlation between eGFR and fibrous volume (r = 0.46, P < 0.0001).

Conclusions:

• Impaired renal function is associated with increased lipid-rich coronary plaque.
• Reduced fibrous plaque components are linked to poorer renal function.
• Findings may elucidate the heightened cardiovascular event risk in renal dysfunction patients.