Morphological Carotid Plaque Area Is Associated With Glomerular Filtration Rate: A Study of South Asian Indian Patients With Diabetes and Chronic Kidney Disease

Abstract

We evaluated the association between automatically measured carotid total plaque area (TPA) and the estimated glomerular filtration rate (eGFR), a biomarker of chronic kidney disease (CKD). Automated average carotid intima–media thickness (cIMTave) and TPA measurements in carotid ultrasound (CUS) were performed using AtheroEdge (AtheroPoint). Pearson correlation coefficient (CC) was then computed between the TPA and eGFR for (1) males versus females, (2) diabetic versus nondiabetic patients, and (3) between the left and right carotid artery. Overall, 339 South Asian Indian patients with either type 2 diabetes mellitus (T2DM) or CKD, or hypertension (stage 1 or stage 2) were retrospectively analyzed by acquiring cIMTave and TPA measurements of their left and right common carotid arteries (CCA; total CUS: 678, mean age: 54.2 ± 9.8 years; 75.2% males; 93.5% with T2DM). The CC between TPA and eGFR for different scenarios were (1) for males and females −0.25 ( P < .001) and −0.35 ( P < .001), respectively; (2) for T2DM and non-T2DM −0.26 ( P < .001) and −0.49 ( P = .02), respectively, and (3) for left and right CCA −0.25 ( P < .001) and −0.23 ( P < .001), respectively. Automated TPA is an equally reliable biomarker compared with cIMTave for patients with CKD (with or without T2DM) with subclinical atherosclerosis.

Nutrition, atherosclerosis, arterial imaging, cardiovascular risk stratification, and manifestations in COVID-19 framework: a narrative review

“…A person's susceptibility to developing atherosclerosis may be identified by the risk factors associated with it. The risk factors responsible for atherosclerotic disease can be categorized into (a) conventional, such as hypertension, obesity, body mass index, ethnicity, gender, ethanol use, and smoking [48] and (b) blood biomarkers such as lipids, hemoglobin A1c (HbA1c) as diabetes index [35,49], estimated glomerular filtration rate (eGFR) as renal index [50], erythrocyte sedimentation rate (ESR) as rheumatoid arthritis index [51], homocysteine, triglycerides, and hCRP/c reactive protein. Fig.…”

“…9 and is preferred as a preventive screening tool [35]. This tool has been applied to the bulb region and correlated to renal scores [50,[180][181][182] or rheumatology patients [183].…”

Does the Carotid Bulb Offer a Better 10-Year CVD/Stroke Risk Assessment Compared to the Common Carotid Artery? A 1516 Ultrasound Scan Study

“…50 The automated plaque area (PA) was measured by accumulating all the pixels within the full-length lumen-intima and media-adventitia interfaces and finally converting the sum from the pixel domain to the mm 2 domain. 43,54,55 Such type of automated plaque area measurement follows the morphology of the plaque (ie, the so-called morphological plaque 43,54 ) throughout the length of the carotid ultrasound scan and also mimics the conventional PA measurement strategy using the manual tracings. 44,45,56,57 The automated measurements of CUSIP were compared against the manual tracings.…”

“…The performance of risk stratification using the AECRS2.0 was evaluated using the area under the curve and "atherosclerosis aggregation factor" against an event-equivalence gold standard (EEGS), which was a combination of glycated hemoglobin (HbA 1c ), estimated glomerular filtration rate (eGFR), and carotid plaque area. 24,[42][43][44][45] A similar type of EEGS has been used as a surrogate marker of CVD/stroke in our previous studies. 20,21,23,24,42 The expansions of all the abbreviations used in this study are presented in Appendix A Table 1.…”

Impaired Renal Function and Cerebrovascular Disease

“…In this issue of Angiology , Puvvula et al 1 report that both carotid intima-media thickness (IMT) and carotid plaque burden, measured as total plaque area (TPA), were increased in patients with impaired renal function, assessed as estimated glomerular filtration rate (eGFR). A recent editorial in this journal explained why measuring plaque burden is superior to measuring IMT, which is biologically and genetically distinct from atherosclerosis, and can be regarded as obsolete technology.…”