title: Chronic kidney disease is associated with increased coronary artery atherosclerosis as revealed by multidetector computed tomographic angiography.
abstract: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular events. We evaluated whether multidetector computed tomographic angiography (MDCTA) revealed a link between pre-dialysis CKD and coronary artery atherosclerosis. We retrospectively analyzed 549 patients who underwent MDCTA. Patients were divided into 3 groups: normal glomerular filtration rate (GFR) (GFR>90 mL/min/1.73 m2 body surface area), mild CKD (>60GFR≤90 mL/min/1.73 m2), and moderate CKD (>30GFR≤60 mL/min/1.73 m2). Normality testing was performed to determine if continuous variables were modeled in Gaussian distribution before analysis of variance was applied. The χ2 test was used to compare GFR subgroups. Multiple linear regression was used to detect associations of total plaque score (TPS), segment involvement score (SIS), and segment stenosis score (SSS) with GFR. A model adjusted for covariates was applied. Patients with mild CKD had a mean TPS 2.3 points higher than those with a normal GFR (P=0.002); patients with moderate CKD had a mean TPS 5.9 points higher than the referent (P<0.001). Patients with mild CKD had a mean SIS 1.1 points higher than those with a normal GFR (P=0.002); patients with moderate CKD had a mean SIS 2.4 points higher than the referent (P<0.001). Patients with mild CKD had a mean SSS 1.4 points higher than those with a normal GFR (P=0.004); patients with moderate CKD had a mean SSS 4.2 points higher than the referent (P<0.001). The use of MDCTA showed that mild and moderate pre-dialysis CKD are independent risk factors for coronary artery atherosclerosis.
authors.affiliation: Division of Cardiology, Department of Medicine, Los Angeles Biomedical Research Center at Harbor-UCLA Medical Center, Torrance, California 90502, USA.
authors.forename: Sion K
authors.initials: SK
authors.lastname: Roy
authors.forename: Albert
authors.initials: A
authors.lastname: Cespedes
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.forename: Tae-young
authors.initials: TY
authors.lastname: Choi
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology; D002140:California / Q000453:epidemiology; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D003331:Coronary Vessels; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Atherosclerosis/etiology; cardiovascular diseases/etiology/prevention & control; disease progression; kidney failure, chronic/complications; retrospective studies; risk factors; tomography, x-ray computed