Relationship between Kidney Function and Subclinical Atherosclerosis Progression Evaluated by Coronary Artery Calcification

Ganbaatar, Namuun; Kadota, Aya; Hisamatsu, Takashi; Araki, Shin‐ichi; Kume, Shinji; Fujiyoshi, Akira; Kadowaki, Sayaka; Torii, Shuki; Kondo, Keiko; Segawa, Hiroyoshi; Salman, Ebtehal; Miyazawa, Itsuko; Yamamoto, Takashi; Nakagawa, Yoshihisa; Maegawa, Hiroshi; Miura, Katsuyuki; Ueshima, Hirotsugu

doi:10.5551/jat.63030

Cited by 11 publications

(10 citation statements)

References 44 publications

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“…For renal biomarkers, our results were consistent with previous studies that demonstrated that CysC was associated with increased arterial stiffness 42 and can be an independent predictor of arterial stiffness in patients with type 2 diabetes mellitus 43 . Similar to previous findings, albuminuria was strongly related to endothelial dysfunction in the early phase of atherosclerosis; this relationship was enhanced in subjects with diabetes, 44 which by itself may predict subclinical atherosclerosis 45 . Existing literature also shows that longitudinal decline in renal function (creatinine and eGFR) is associated with higher levels of PWV 46 .…”

Section: Discussionsupporting

confidence: 84%

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Liang

Zhou

Chen

et al. 2023

Journal of Diabetes

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BackgroundArterial stiffness contributes to additional cardiovascular risks in diabetic patients by triggering the loss of vascular and myocardial compliance and promoting endothelial dysfunction. Thus, prevention of arterial stiffness is a public health priority, and the identification of potential biomarkers may provide benefits for early prevention. This study investigates the relationships between serum laboratory tests and pulse wave velocity (PWV) tests. We also investigated the associations between PWV and all‐cause mortality.MethodsWe examined a panel of 33 blood biomarkers among diabetic populations in the Atherosclerosis Risk in Communities Study. The carotid‐femoral (cfPWV) and femoral‐ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The aortic‐femoral arterial stiffness gradient (afSG) was calculated as faPWV divided by cfPWV. Biomarker levels were log‐transformed and correlated with PWV. Cox proportional hazard models were employed for survival analysis.ResultsAmong 1079 diabetic patients, biomarkers including high‐density lipoprotein cholesterol, glycated hemoglobin, high‐sensitivity troponin T, cystatin C, creatinine, and albuminuria were significantly correlated with afSG (R = 0.078, −0.193, −0.155, −0.153, −0.116, and −0.137, respectively) and cfPWV (R = −0.068, 0.175, 0.128, 0.066, 0.202, and 0.062, respectively). Compared with the lowest tertile of afSG, the risk of all‐cause mortality was lower in the highest tertile (hazard ratio 0.543; 95% confidence interval 0.328–0.900).ConclusionCertain biomarkers related to blood glucose monitoring, myocardial injury, and renal function significantly correlated with PWV, suggesting that these putative risk factors are likely to be important atherosclerosis mechanisms in diabetic patients. AfSG may be an independent predictor of mortality among diabetic populations.

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Section: Discussionsupporting

confidence: 84%

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Liang

Zhou

Chen

et al. 2023

Journal of Diabetes

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“…Hemodialysis is a well-known predictor for worse clinical outcomes after PCI, which was in line with the results of the current study. There is a significant association between kidney function and coronary artery calcification 29) . Moreover, Lee et al reported that hemodialysis is the independent predictor of CN 15) .…”

Section: Worse Clinical Outcomes Of Cnmentioning

confidence: 99%

Clinical Outcomes and Unique Restenosis of Calcified Nodule in Heavily Calcified Coronary Artery

Jinnouchi

Sakakura

Taniguchi

et al. 2023

JAT

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Aims: Calcified nodule (CN) has been known as the advanced stage of coronary calcification. However, clinical outcomes following percutaneous coronary intervention (PCI) to CN remain unknown. This study aimed to compare clinical outcomes, including target lesion revascularization (TLR), between calcified coronary lesions with and without CN. Methods: Two hundred forty-nine lesions undergoing intravascular ultrasound-guided PCI with rotational atherectomy (RA) were enrolled and divided into the CN group (n=100) and the non-CN group (n=149) according to the presence of CN. The cumulative incidence of clinically driven TLR (CD-TLR) and the reasons for CD-TLR were compared between the CN and non-CN groups.Results: The incidence of CD-TLR was significantly higher in the CN group than in the non-CN group. In the landmark analysis at 1 year, the CN group showed a significantly higher incidence of CD-TLR within 1 year. However, the incidence of CD-TLR beyond 1 year was numerically lower in the CN group than in the non-CN group. In the multivariate Cox hazard model, CN was significantly associated with CD-TLR. In the CN group, in-stent CN was the major reason for CD-TLR (52%) and was observed mainly within 1 year (90%). Conclusions:In the heavily calcified lesions requiring RA, CN was the factor associated with the higher rate of CD-TLR especially within 1 year. The timing of CD-TLR in lesions with CN may indicate that the process of CN protruding through the struts was progressed monthly.

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“…In recent years, GFR and renal injury assessed by CysC have received increasing attention 24 , 25 . Studies have reported that eGFRcys is associated with tumors, subclinical atherosclerosis and coronary artery calcification 26 , 27 . However, few studies have focused on changes in eGFRcys after stroke and its association with stroke prognosis.…”

Section: Discussionmentioning

confidence: 99%

Lower glomerular filtration rate after mild stroke induces cognitive impairment by causing endothelial dysfunction

Shang,

Yan,

Chen

2024

Sci Rep

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The incidence of post stroke cognitive impairment (PSCI) is high in patients with mild stroke (MIS), and the risk factors and mechanism are uncertain. Increased cystatin C (CysC) levels after stroke may reflect lower glomerular filtration rate (GFR) and renal impairment. Previous studies have suggested endothelial dysfunction (ED) is closely related to renal impairment and cognitive impairment, respectively. We aimed to observe whether lower GFR estimated by CysC after MIS leaded to a high incidence of PSCI, and the role of ED in this process. 256 patients were enrolled in this prospective observational study. Renal function was assessed using GFR estimated by serum CysC. Endothelial function was evaluated by reactive hyperemia index (RHI) which calculated automatically by peripheral arterial tonometry (PAT). The cognitive function at baseline and 3 months was evaluated by MoCA score, and MoCA score ≤ 26 indicates the presence of PSCI. Spearman correlation analysis and linear regression were conducted to explore the factors affecting ED. Univariate and multivariate analysis was used to identify the independent risk factors of PSCI. The receiver operating characteristic (ROC) curve was applied to explore the optimal cutoff value of the independent risk factors levels for predicting PSCI. A total of 141 patients (55.1%) suffered from ED. Multiple linear regression analysis showed that there was a strong linear correlation between eGFRcys and RHI (p < 0.001). At the three-month follow-up, a total of 150 (58.6%) patients had been diagnosed with PSCI. Multivariate logistic regression analysis showed that RHI was an independent factor affecting the occurrence of PSCI (p < 0.05). ROC curve showed that the area under the curve was 0.724, and the optimal cut-off value of RHI was 1.655, with the sensitivity and specificity for PSCI were 72.7% and 73.6%, respectively. The lower eGFRcys level after MIS was significantly associated with ED, and ED may mediate the higher incidence of PSCI at 3 months after MIS.

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Relationship between Kidney Function and Subclinical Atherosclerosis Progression Evaluated by Coronary Artery Calcification

Cited by 11 publications

References 44 publications

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Clinical Outcomes and Unique Restenosis of Calcified Nodule in Heavily Calcified Coronary Artery

Lower glomerular filtration rate after mild stroke induces cognitive impairment by causing endothelial dysfunction

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