title: Composition and plaque patterns of coronary culprit lesions and clinical characteristics of patients with chronic kidney disease.
abstract: Coronary artery disease is a serious complication of chronic kidney disease (CKD); however, there is little information about coronary plaque morphology in these patients. Here we identified the characteristics of coronary culprit plaques and their clinical manifestations in 78 patients with CKD divided into four groups based on their estimated glomerular filtration rate. Patients were examined by Virtual Histology-Intravascular Ultrasound, a tomographic imaging method that can visualize atherosclerotic plaques in vivo using radiofrequency analysis of ultrasound backscatter signals. These ultrasound analyses showed an increase in the relative volumes of both dense calcium and necrotic core with decreasing renal function. The necrotic core/dense calcium ratio was significantly higher in patients with acute myocardial infarction compared to those with stable angina pectoris. Furthermore, the necrotic core/dense calcium ratio decreased in advanced CKD. Thus, the plaque composition of coronary culprit lesions changed from necrotic core-rich to extensively calcium-rich plaques as renal function decreased, suggesting that such coronary culprit composition was associated with stability, particularly in advanced CKD.
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Kono
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakai
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Goto
authors.forename: Junya
authors.initials: J
authors.lastname: Shite
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Hirata
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000209:etiology / Q000473:pathology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000473:pathology; D009336:Necrosis; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D014463:Ultrasonography; D061205:Vascular Calcification / Q000473:pathology