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Coronary calcifications and plaque characteristics in patients with end-stage renal disease: a computed tomographic

Borut Jug1, Jigar Kadakia, Mohit Gupta

  • 1Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, CA 90502, USA.

Coronary Artery Disease
|July 2, 2013
PubMed

Insights

Patients with end-stage renal disease (ESRD) show more calcified plaques and diffuse atherosclerosis. However, coronary artery calcium scoring accurately predicts atherosclerotic burden in both ESRD and non-ESRD individuals.

Area of Science:

  • Cardiovascular Imaging
  • Nephrology
  • Radiology

Background:

  • End-stage renal disease (ESRD) is linked to increased cardiovascular risk.
  • Coronary artery calcifications (CAC) and atherosclerotic plaque burden are key indicators of cardiovascular disease.
  • Understanding plaque morphology in ESRD patients is crucial for risk stratification.

Purpose of the Study:

  • To investigate the association between CAC, atherosclerotic burden, and plaque morphology in ESRD patients.
  • To compare these findings with non-ESRD individuals undergoing coronary computed tomographic angiography.
  • To evaluate the utility of calcium scoring in assessing atherosclerosis in ESRD.

Main Methods:

  • Utilized 64-slice multidetector coronary computed tomographic angiography.
  • Quantified prevalence, extent, and severity of coronary atherosclerosis, calcium burden, and plaque morphology.
  • Compared ESRD patients (n=48) with calcium score-matched (n=39) and unmatched (n=29) non-ESRD controls.
  • Employed dedicated plaque imaging software for analysis.

Main Results:

  • ESRD patients exhibited a higher prevalence of calcified plaques (55.9% vs. 38.3% and 26.9%) and greater plaque calcium content (43.7% vs. 34.5% and 33.9%).
  • Coronary artery calcium score strongly correlated with plaque burden in both ESRD (r=0.403) and non-ESRD (r=0.433) groups.
  • The diagnostic accuracy of calcium scoring for atherosclerotic lesions was comparable between ESRD and non-ESRD groups (AUC 0.771 vs. 0.804).

Conclusions:

  • End-stage renal disease is associated with more widespread atherosclerosis and calcific plaque morphology.
  • Coronary artery calcium scoring remains a reliable tool for assessing atherosclerotic burden, irrespective of ESRD status.
  • These findings highlight the importance of cardiovascular risk assessment in ESRD patients.
Abstract

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