title: Coronary plaque characteristics in patients with mild chronic kidney disease. Analysis by 320-row area detector computed tomography.
abstract: BACKGROUND
  The differences in the coronary plaque characteristics between patients with mild chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] 30-59 ml·min(-1) · 1.73 m(-2)) and those without CKD (eGFR ≥60) by 320-row area detector computed tomography (CT) have not been studied.
  
  
  RESULTS
  We enrolled 487 patients undergoing coronary CT angiography with suspected stable coronary artery disease (mean age: 66.6±10.8 years, 131 with mild CKD) and analyzed 6,352 segments. All coronary plaques were characterized for the presence of vessel remodeling, plaque consistency and the disposition of coronary calcification, and a plaque with positive vessel remodeling and/or low-attenuation was defined as high risk. The number of diseased segments per patient was higher in mild CKD patients than in those without CKD (4.61±3.83 vs. 2.95±3.11, P<0.0001). The prevalence of severe stenosis (≥70% luminal diameter) was significantly higher in cases of mild CKD than in no CKD (35.1% vs. 19.4%, P=0.0003), but there was no significant difference in the prevalence of high-risk plaque (13.0% vs. 9.8%, P=0.3189).
  
  
  CONCLUSIONS
  The severity of coronary artery stenosis was higher in the patients with mild CKD, though there was no significant difference in the prevalence of high-risk plaque. We suggest that the high risk of coronary events in patients with CKD is related to the severity of stenosis rather than to the characteristics of plaque.
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kawai
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Sarai
authors.forename: Sadako
authors.initials: S
authors.lastname: Motoyama
authors.forename: Hiroto
authors.initials: H
authors.lastname: Harigaya
authors.forename: Hajime
authors.initials: H
authors.lastname: Ito
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sanda
authors.forename: Shankar
authors.initials: S
authors.lastname: Biswas
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Anno
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishii
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index