Impact of renal function on coronary plaque composition

Miyagi, Motohiro; Ishii, Hideki; Murakami, Ryuichiro; Isobe, Satoshi; Hayashi, Mutsuharu; Amano, Tetsuya; Arai, Kosuke; Yoshikawa, Daiji; Ohashi, Taiki; Uetani, Tadayuki; Yasuda, Yoshinari; Matsuo, Seiichi; Murohara, Toyoaki

doi:10.1093/ndt/gfp423

Cited by 58 publications

(35 citation statements)

References 34 publications

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“…We previously demonstrated that patients with CKD had larger lipid profiles and a higher prevalence of plaque disruption compared with patients without CKD, although we found no significant difference in FCT at the thinnest portion across groups 31. Using integrated backscatter intravascular ultrasonography, Miyagi et al demonstrated that coronary plaques in patients with CKD had greater lipid and less fibrous tissue volume in 89 patients with stable angina 32. Hayano et al further demonstrated that lower eGFR levels were associated with greater lipid and lower fibrous content 33.…”

Section: Discussioncontrasting

confidence: 49%

Clinical Predictors for Lack of Favorable Vascular Response to Statin Therapy in Patients With Coronary Artery Disease: A Serial Optical Coherence Tomography Study

Minami

Wang

Aguirre

et al. 2017

JAHA

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BackgroundPrevious studies have demonstrated that statin therapy improves cardiac outcomes, probably by stabilizing thin‐cap fibroatheroma in patients with coronary artery disease. However, major adverse cardiac events still occur in some patients, despite statin therapy. The aim of this study is to identify clinical predictors for the lack of a favorable vascular response to statin therapy in patients with coronary artery disease.Methods and ResultsA total of 140 nonculprit plaques from 84 patients with coronary artery disease who were treated with a statin and had serial optical coherence tomography imaging (median interval, 6.3 months) were included. Thin‐cap area (fibrous cap thickness, <200 μm) was measured using a novel 3‐dimensional computer‐aided algorithm. Overall, the thin‐cap area significantly decreased from baseline (median, 2.852 mm2; 25th–75th percentile, 1.023–6.157 mm2) to follow‐up (median, 1.210 mm2; 25th–75th percentile, 0.250–3.192 mm2; P<0.001), and low‐density lipoprotein cholesterol significantly decreased from baseline (mean±SD, 92.9±30.1 mg/dL) to follow‐up (mean±SD, 76.3±23.3 mg/dL; P<0.001). The general linear model with multiple predictor variables revealed that the thin‐cap area was significantly higher in patients with chronic kidney disease than in those without it (regression coefficient b, 1.691 mm2; 95% confidence interval, 0.350–3.033 mm2; P=0.013) and lower in patients with acute coronary syndrome (regression coefficient b, −1.535 mm2; 95% confidence interval, −2.561 to −0.509 mm2; P=0.003).ConclusionsChronic kidney disease is an independent predictor for the lack of a favorable vascular response to statin therapy, whereas acute coronary syndrome is an independent predictor for favorable vascular response to statin therapy. These findings should be further warranted in future prospective studies.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01110538.

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Section: Discussioncontrasting

confidence: 49%

Clinical Predictors for Lack of Favorable Vascular Response to Statin Therapy in Patients With Coronary Artery Disease: A Serial Optical Coherence Tomography Study

Minami

Wang

Aguirre

et al. 2017

JAHA

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“…Recently, IB-IVUS has added to perform analysis of the tissue components of coronary plaque in vivo, 3 and studies using this technique have revealed that patients with coronary risk factors including high insulin levels, metabolic syndrome, diabetes, and/or chronic kidney disease have a high prevalence of lipid-rich coronary plaque. 24, 25 It is well established that high serum levels of LDL-C constitute a strong predictor of CHD, and that LDL-C-lowering therapy reduces CHD. 26 The LDL-C/HDL-C ratio was found to be a more accurate in determining CHD risk, compared to LDL-C or HDL-C alone.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Low- to High-Density Lipoprotein Cholesterol Ratio on Composition of Angiographically Ambiguous Left Main Coronary Artery Plaque

Kurebayashi

Yoshikawa

Ishii

et al. 2011

Circ J

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“…Indeed, the impact of pioglitazone on atheroma volume depends not only on the hypoglycemic effect but also on reduction in the levels of inflammatory biomarkers, triglycerides, and elevation of HDL-C. 31 It has been reported that renal dysfunction is associated with severity of coronary atherosclerosis 32 and higher proportion of lipid volume. 33 Furthermore, risk of cardiac events was associated with eGFR and the presence of DM. 34 Consistent with previous findings, significant negative correlations were observed between atheroma volume at follow-up and eGFR, and FF volume at follow-up tended to be negatively correlated with eGFR in the present study.…”

Section: Discussionmentioning

confidence: 98%

Impact of Diabetes Mellitus on Coronary Atherosclerosis and Plaque Composition Under Statin Therapy

Nozue

Yamamoto

Tohyama

et al. 2012

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp iabetes mellitus (DM) is a risk factor for the development of coronary artery disease (CAD), 1 and DM patients have a markedly increased incidence of adverse cardiovascular events. 2 The mechanisms underlying this increased incidence, however, have not been well-characterized.Recent clinical trials using gray-scale intravascular ultrasound (IVUS) have shown that intensive lipid-lowering therapy with statins resulted in regression of coronary artery plaques 3 and reduced the risk of coronary events.

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Impact of renal function on coronary plaque composition

Abstract: 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.

Cited by 58 publications

References 34 publications

Clinical Predictors for Lack of Favorable Vascular Response to Statin Therapy in Patients With Coronary Artery Disease: A Serial Optical Coherence Tomography Study

Clinical Predictors for Lack of Favorable Vascular Response to Statin Therapy in Patients With Coronary Artery Disease: A Serial Optical Coherence Tomography Study

Impact of the Low- to High-Density Lipoprotein Cholesterol Ratio on Composition of Angiographically Ambiguous Left Main Coronary Artery Plaque

Impact of Diabetes Mellitus on Coronary Atherosclerosis and Plaque Composition Under Statin Therapy

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