Renal function is one of the determinant factors of subclinical coronary calcification. An intravascular ultrasound virtual histology study

Abstract

Background: Chronic kidney disease is considered one of the most important cardiovascular risks and the relation between coronary calcium and renal function has been reported. However, its relation in non-culprit lesion is not fully elucidated. Objectives: The purpose of this study was to clarify the relation between coronary calcium evaluated by VH-IVUS and renal function in non-culprit coronary lesions. Methods: Non-culprit coronary plaques of 341 patients (groupA, n=217 e-GFR ≥60: groupB, n=124 e-GFR<60) with ischemic heart disease were imaged by intravascular ultrasound. External elastic membrane CSA (EEM-CSA) and lumen CSA (lumen-CSA) were measured. Plaque burden, eccentricity index and Plaque + Media CSA (P+M CSA); (EEM-CSA)-(lumen CSA) were calculated. Plaque composition was classified into 4 categories, Fibrous (F), Fibro-fatty (FF), Dense calcium (DC) and Necrotic core (NC) using Virtual-Histology software. Results: There was no difference in plaque burden, EEM-CSA, P+M CSA, F% and NC% between 2 groups, however, FF% was significantly smaller (11.0±7.5 vs 13.2±7.9, p=0.01) and DC% was significantly larger (12.1±10.3 vs 9.6±8.3, p=0.02) in groupB than in groupA. Multivariate analysis showed that female (p=0.02) and e-GFR (p=0.01) were determinant factors of relative volume of dense calcium by VH-IVUS. Conclusions: In patients with CKD, non-culprit coronary plaques contained larger amount of dense calcium and less fibro-fatty tissue compared without CKD patients. Renal function is one of the determinant factors of subclinical coronary calcification in non-culprit coronary lesions.