Abstract 5820: Impact of Renal Function on Coronary Plaque Composition at Angiographically Severe Lesions

Abstract

Background: Recent studies have demonstrated that patients with chronic kidney disease are at high risk of arteriosclerosis. Recently, coronary plaque components can be evaluated by integrated-backscatter intravascular ultrasound (IB-IVUS) and lipid-rich plaque is associated with vulnerable plaque. Objective: The aim of this study was to investigate the relationship between renal function and tissue characterization of coronary plaque at the target stenotic site for percutaneous coronary intervention (PCI). Methods: We prospectively performed IB-IVUS before elective PCI to 89 consecutive patients with stable angina. According to estimated glomerular filtration rate (eGFR), they were divided into the two groups (eGFR < 60 ml/min/1.73m 2 or eGFR ≥ 60 ml/min/1.73m 2 ). The tissue characteristics of the coronary plaque at each target stenotic site were evaluated by three-dimensional IB-IVUS just before PCI procedure. Results: Patients with eGFR < 60 ml/min/1.73m 2 had greater lipid volume and smaller fibrous volume compared to patients with eGFR ≥ 60 ml/min/1.73m 2 on the 3-D IB-IVUS image (36.7±10.6 % vs. 28.7±9.3 %, p < 0.001 and 59.1±8.7 % vs. 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 < 0.001, and r = 0.46, p <0.001, respectively). Conclusion: These data suggest that there is a progressive increase in lipid-rich plaque as renal function deteriorated. Our findings may explain the increasing risk of cardiovascular events in patients with renal dysfunction.