title: Intravascular Ultrasound Analysis of Correlation between Plaque-Morphology and Risk Factors in Peripheral Arterial Disease.
abstract: OBJECTIVE
  To analyze relationships between plaque-morphology classified by intravascular ultrasound (IVUS) and risk factors in patients with peripheral arterial disease (PAD).
  
  
  METHODS
  We performed IVUS in 203 patients with PAD. Multiple regression and logistic analysis were used to assess relationships between plaque-morphology (degree of calcification, presence of a lipid core, intimal flap and thrombus) and risk factors including diabetes mellitus, hypertension, dyslipidemia, estimated glomerular filtration rate (eGFR), HbA1c and the homeostasis model assessment-insulin resistance ratio (HOMA-IR).
  
  
  RESULTS
  IVUS data led to 22% of lesions being classified as soft, 18% as fibrous, 32% as calcified, and 28% as mixed. Calcification was present in the superficial and deep layers in 65% and 35% of cases, respectively, and a lipid core, intimal flap and thrombus were found in 31%, 5.4% and 3.0%, respectively. The calcified angle correlated with HbA1c and eGFR (p < 0.05). Associations were found between deep calcification and HOMA-IR (odds ratio: 4.4, p < 0.05) and a lipid core and hypercholesterolemia (odds ratio: 3.2, p < 0.05). The odds ratio for intimal flap was 15.6 times with hypercholesterolemia (p < 0.05) and 16.9 times with a high HOMA-IR (p < 0.01).
  
  
  CONCLUSIONS
  Plaque calcification and morphology are associated with chronic kidney disease, insulin resistance and dyslipidemia in PAD patients.
authors.affiliation: Department of Vascular Medicine, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Gunma, Japan.
authors.forename: Nogiku
authors.initials: N
authors.lastname: Niwamae
authors.forename: Hisao
authors.initials: H
authors.lastname: Kumakura
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kanai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Araki
authors.forename: Shu
authors.initials: S
authors.lastname: Kasama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sumino
authors.forename: Shuiehi
authors.initials: S
authors.lastname: Iehikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Hasegawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
keywords: calcification; chronic kidney disease; intravascular ultrasound; peripheral arterial disease; plaque-morphology
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