Abstract 11015: Impact of Indoxyl Sulfate, a Uremic Toxin, on Carotid Intima-Media Thickness in Patient with Stable Angina Pectoris
Background: The association of chronic kidney disease (CKD) with poor clinical outcome has been widely reported. Indoxyl sulfate (IS), a uremic toxin, accelerates the progression of cardiovascular disease (CVD), as well as CKD. On the other hand, carotid plaque intima-media thickness (IMT) assessment using ultrasound well predicts future CVD. The aim of this study was to investigate relationship between serum levels of IS and carotid IMT in patients with ischemic heart disease.
Methods: This study consisted of 84 patients undergoing percutaneous coronary intervention. Carotid artery was evaluated using high-resolution ultrasound prior to PCI. Mean max-IMT defined as the mean maximal wall thickness of the six segments (near and far walls of the bilaterally common carotid artery, carotid bifurcation, and internal carotid artery) was adapted as an indicator of the severity of carotid atherosclerosis.
Results: Serum IS levels had significantly negative correlation with eGFR (r = -0.377, p <0.001). Patients were divided into the two groups according to the median of serum IS levels (high IS or low IS group, median = 0.73 ug/ml). Patients in the high IS group had significantly large mean max-IMT than those in the low IS group (1.50 ± 0.48mm vs. 1.26 ± 0.36mm, P=0.009). Notably, on multivariate linear regression analysis, IS, but not eGFR, was an independent predictor for mean max-IMT (β = 0.228, p = 0.048 and β = -0.209, p = 0.07).
Conclusions: In patient with ischemic heart disesase, high serum IS levels were associated with large mean max-IMT which is a potent predictor for future CVD. Therefore, IS might be possible to be a therapeutic target for both CKD and CVD to improve prognosis in high risk patients.
- © 2011 by American Heart Association, Inc.