Impact of renal function on coronary plaque composition

2009 Fiscal Year Final Research Report

• Project/Area Number: 20790522
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Single-year Grants
• Research Field: Circulatory organs internal medicine
• Research Institution: Nagoya University
• Principal Investigator: ISHII Hideki Nagoya University, 医学部・附属病院, 助教 (90456674)
• Project Period (FY): 2008 – 2009
• Keywords: 循環器 / 慢性腎疾患 / 冠動脈 / 動脈硬化 / 血管内超音波

Research Abstract

Background : Recent studies have demonstrated that patients with chronic kidney disease are at high risk of atherosclerosis. Recently, coronary plaque components can be evaluated by integrated-backscatter intravascular ultrasound (IB-IVUS) and lipid-rich plaque is associated with vulnerable plaque. This aim of the study was to investigate relationship between renal function and tissue characterization of coronary plaque composition at the target stenotic site for percutaneous coronary intervention (PCI).
Methods : We prospectively performed IB-IVUS before elective PCI to 89 consecutive patients with stable angina. According to estimated glomerular filtration rate (eGFR), they were divided into the two groups (eGFR<60 ml/min/1.73m2 or eGFR≧60 ml/min/1.73m2). The tissue characteristics of the coronary plaque at each target stenotic site were evaluated by three-dimensional IB-IVUS just before PCI procedure.
Results : Patients with eGFR<60 ml/min/1.73m2 had higher percentage of lipid volume and lower percentage of fibrous volume compared to patients with eGFR≧60 ml/min/1.73m2 on the 3-D IB-IVUS images (36.7±10.6% vs.28.7±9.3%, P<0.001 and 59.1±8.7% vs. 66.3±8.3%, P<0.001, respectively). eGFR showed a significant negative correlation with lipid volume and had a significant positive correlation with fibrous volume in coronary plaques(r=-0.44, p<0.0001, and r=0.46, p<0.0001, respectively)
Conclusions : Impaired renal function was related to higher percentage of lipid volume and lower percentage of fibrous volume in coronary plaque. Our findings may explain the increasing risk of cardiovascular events in patients with renal dysfunction.

Research Products

• [Journal Article] Impact of renal function on coronary plaque composition. (2010)
  • Author(s): Miyagi M, Ishii H, Murakami R, Isobe S, Hayashi M, Amano T, Arai K, Yoshikawa D, Ohashi T, Uetani T, Yasuda Y, Matsuo S, Matsubara T, Murohara T.
  • Journal Title: Nephrol Dialysis Transplantation 25 Pages: 175-181
  • Peer Reviewed
• [Journal Article] Impact of chronic statin therapy on coronary plaque composition at angiographically severe lesions: a non-randomized study focused on history of chronic statin treatment before coronary angioplasty. (2009)
  • Author(s): Miyagi M, Ishii H, Murakami R, Isobe S, Hayashi M, Amano T, Kosuke A, Ohashi T, Uetani T, Matsubara T, Murohara T.
  • Journal Title: Clin Ther. 31 Pages: 64-73
  • Peer Reviewed
• [Presentation] Impact of renal function on coronary plaque composition. (2009)
  • Author(s): Miyagi M, Ishii H, Murakami R, Isobe S, Hayashi M, Amano T, Kosuke A, Ohashi T, Uetani T, Matsubara T, Murohara T.
  • Organizer: American Heart Association Scientific Sessions 2009
  • Place of Presentation: Orland Florida USA
  • Year and Date: 2009-11-15
• [Presentation] Plaque Burden at Left Main Coronary Artery of Patients Undergoing Percutaneous Coronary Intervention with Metabolic Syndrome. (2008)
  • Author(s): Miyagi M, Ishii H, Murakami R, Isobe S, Hayashi M, Amano T, Kosuke A, Ohashi T, Uetani T, Matsubara T, Murohara T.
  • Organizer: American Heart Association Scientific Sessions 2008
  • Place of Presentation: New Orleans, Louisiana USA
  • Year and Date: 2008-11-09