title: Impact of renal function on coronary plaque composition.
abstract: BACKGROUND
  Recent studies have demonstrated that patients with chronic kidney disease are at high risk of atherosclerosis. Recently it has been found that coronary plaque components can be evaluated by integrated backscatter intravascular ultrasound (IB-IVUS), and lipid-rich plaque is associated with vulnerable plaque. The aim of the study was to investigate the 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 in 89 consecutive patients with stable angina. According to estimated glomerular filtration rate (eGFR), they were divided into two groups (eGFR <60 ml/min/ 1.73 m(2) or eGFR > or =60 ml/min/1.73 m(2)). The tissue characteristics of the coronary plaque at each target stenotic site were evaluated by three-dimensional (3D) IB-IVUS just before PCI procedure.
  
  
  RESULTS
  The patients with eGFR <60 ml/min/1.73 m(2) had higher percentage of lipid volume and lower percentage of fibrous volume compared to the patients with eGFR > or = 60 ml/min/1.73 m(2) on the 3D IB-IVUS images (36.7 +/- 10.6% versus 28.7 +/- 9.3%, P < 0.001 and 59.1 +/- 8.7% versus 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.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Miyagi
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Murakami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Isobe
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.forename: Kosuke
authors.initials: K
authors.lastname: Arai
authors.forename: Daiji
authors.initials: D
authors.lastname: Yoshikawa
authors.forename: Taiki
authors.initials: T
authors.lastname: Ohashi
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Uetani
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Matsubara
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002318:Cardiovascular Diseases / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D050356:Lipid Metabolism / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018084:Ultrasonography, Interventional