Coronary calcifications and plaque characteristics in patients with end-stage renal disease

Abstract

We examined the association between coronary artery calcifications, atherosclerotic burden, and plaque morphology in end-stage renal disease (ESRD) and non-ESRD patients undergoing 64-slice multidetector coronary computed tomographic angiography. The prevalence, extent, and severity of coronary atherosclerosis, calcium burden, and plaque morphology were determined in ESRD patients (n=48), and calcium score-matched (n=39) and unmatched non-ESRD controls (n=29) undergoing computed tomographic angiography using dedicated plaque imaging software. ESRD was associated with a higher prevalence of calcified plaques (55.9% vs. 38.3 and 26.9% in the non-ESRD groups, P=0.005) and higher plaque calcium content (43.7 vs. 34.5% and 33.9%; P=0.003). Nonetheless, the calcium score correlated well with plaque burden (r=0.403 in ESRD vs. r=0.433 in non-ESRD, P<0.001 for both), and the diagnostic association between the calcium score and atherosclerotic lesions was good irrespective of ESRD (area under the curve 0.771 vs. 0.804; P=0.574). ESRD is associated with diffuse atherosclerosis and calcific plaque morphology. Nonetheless, the association between the calcium score and atherosclerotic burden is not affected by the presence of ESRD.