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Correlation of coronary plaque characteristics and obstructive stenosis with chronic kidney disease by coronary CT
Chengming Wang1, Guanxun Cheng1, Yibo Duanmu1
11 Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Imaging Department, Peking University Shenzhen Hospital, Shenzhen 518036, China.
Insights
Chronic kidney disease (CKD) significantly increases the risk of coronary artery disease (CAD). Impaired kidney function correlates with more severe coronary plaque and obstructive stenosis, highlighting CKD as a critical CAD risk factor.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Chronic kidney disease (CKD) is a known independent risk factor for cardiovascular events.
- The relationship between CKD, coronary plaque characteristics, and obstructive stenosis requires further elucidation.
Purpose of the Study:
- To evaluate the correlation between coronary plaque characteristics and obstructive stenosis with CKD using coronary computed tomographic angiography (CCTA).
Main Methods:
- 491 subjects with suspected coronary artery disease (CAD) underwent CCTA.
- Estimated glomerular filtration rate (eGFR) was calculated using the MDRD equation.
- Patients were categorized into four groups based on eGFR levels, from normal to severe renal insufficiency.
Main Results:
- Spearman correlation analysis revealed a positive correlation between CKD and the prevalence of any plaque, calcified plaque (CP), and mixed plaque (MP).
- After adjusting for traditional risk factors, CKD remained positively correlated with any plaque and MP.
- CKD also showed a positive correlation with any stenosis and severe stenosis, which persisted after risk factor adjustment.
Conclusions:
- CKD is closely associated with the occurrence of CAD.
- Mild to severe renal insufficiency are risk factors for CAD.
- Worsening renal function impairment indicates a higher risk of coronary plaque and obstructive stenosis.
Background:
Chronic kidney disease (CKD) is an independent risk factor for cardiovascular events. We evaluated the correlation of coronary plaque characteristics and obstructive stenosis with CKD by coronary computed tomographic angiography (CCTA).
Methods:
We enrolled 491 subjects who were suspected coronary artery disease (CAD) undergoing CCTA. Estimated glomerular filtration rate (eGFR) was calculated by the modification of diet in renal disease (MDRD) equation. Patients were subdivided into four groups based on their eGFR: normal GFR (n=213, eGFR ≥90 mL/min/1.73 m(2)), mild renal insufficiency (n=191, eGFR 60-89 mL/min/1.73 m(2)), moderate renal insufficiency(n=78, eGFR <60 mL/min/1.73 m(2), ≥30 mL/min/1.73 m(2)), and severe renal insufficiency (n=9, eGFR <30 mL/min/1.73 m(2), ≥15 mL/min/1.73 m(2)).
Results:
Spearman correlation regression analysis showed that the prevalence of any plaque, calcified plaque (CP), mixed plaque (MP) were positively correlate with CKD (r=0.173, P<0.001; r=0.127, P=0.005; r=0.171, P<0.001), after adjustment for traditional risk factors the prevalence of any plaque and MP were still positively correlate with CKD (r=0.106, P=002; r=0.178, P<0.001). And the prevalence of any stenosis and severe stenosis were positively correlate with CKD (r=0.13, P<0.001; r=0.149, P<0.001), after adjustment for traditional risk factors were still positively correlate with CKD (r=0.134, P=0.003; r=0.174, P<0.001).
Conclusions:
CKD is closely related with occurrence of CAD. CKD patients from mild renal insufficiency to severe renal insufficiency are the risk factors for CAD. More serious renal function impairment will indicates higher risk of coronary plaque, MP and obstructive stenosis.
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