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Influence of chronic kidney disease on coronary plaque components in coronary artery disease patients with both diabetes mellitus and hypertension

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Abstract

Chronic kidney disease (CKD) is well known to be associated with an increased incidence of coronary artery disease (CAD). Diabetes mellitus (DM) and hypertension (HTN), both of which are traditional risk factors for CAD, are the two most common causes of CKD. However, the influence of CKD on coronary atherosclerosis in CAD patients who have both DM and HTN remains uncertain. In these patients, we examined the relationship between CKD and coronary plaque using integrated backscatter intravascular ultrasound (IB IVUS). Two hundred two CAD patients with both DM and HTN who underwent percutaneous coronary intervention using IB IVUS were included. The patients were divided into two groups: CKD group (n = 106) and non-CKD group (n = 96). Gray-scale and IB IVUS examinations were conducted for the non-culprit segment of a coronary artery. As a result, although there was no significant difference in the percentage of plaque volume, the percentage of lipid volume was significantly higher in the CKD group than in the non-CKD group [median (IQR): 56.7% (45.4–67.0%) vs. 52.0% (38.3–60.2%), p = 0.03]. In all of the patients, estimated glomerular filtration rate levels were negatively correlated with the percentage of lipid volume (r = − 0.15, p = 0.03) and positively correlated with the percentage of fibrosis volume (r = 0.15, p = 0.04). A multivariate regression analysis showed that CKD was an independent predictor associated with the increased lipid volume (β = 0.15, p = 0.047) and decreased fibrosis volume (β = − 0.16, p = 0.03) in coronary plaques. In conclusion, among CAD patients who had both DM and HTN, CKD was associated with lipid-rich coronary plaques. CKD may contribute to the vulnerability of coronary plaque in these very high-risk patients.

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Authors and Affiliations

  1. Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan

    Eiji Shigemoto, Atsushi Iwata, Makito Futami, Yuta Kato, Motoki Yamashita, Takashi Kuwano, Amane Ike, Makoto Sugihara, Keijiro Saku & Shin-ichiro Miura

  2. Department of Clinical Research and Ethics Center, Fukuoka University School of Medicine, Fukuoka, Japan

    Satoshi Imaizumi

  3. Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan

    Keijiro Saku & Shin-ichiro Miura

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  1. Eiji Shigemoto
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Correspondence to Atsushi Iwata.

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KS and SM are Directors of NPO Clinical and Applied Science, Fukuoka, Japan. KS and SM received a Grant from the Public Interest Incorporated Foundation of “Clinical Research Promotion Foundation” in Fukuoka, Japan, and part of this work was transferred to NPO Clinical and Applied Science, Fukuoka, Japan. KS has an Endowed Department of Molecular Cardiovascular Therapeutics (SM), Fukuoka University, supported by MSD Co., Ltd.

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Shigemoto, E., Iwata, A., Futami, M. et al. Influence of chronic kidney disease on coronary plaque components in coronary artery disease patients with both diabetes mellitus and hypertension. Heart Vessels 34, 1065–1075 (2019). https://doi.org/10.1007/s00380-018-01334-5

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