Abstract 11513: Impact of Indoxyl Sulfate, a Uremic Toxin, on Non-Culprit Coronary Plaque Composition Assessed by Integrated Backscatter Intravascular Ultrasound in Patients With Coronary Artery Disease
Backgrounds: Uremic toxin has emerged as an important determinant of cardiovascular risk. The aim of this study was to examine the relationship between uremic toxin levels and coronary plaque vulnerability assessed by integrated backscatter intravascular ultrasound (IB-IVUS) during percutaneous coronary intervention.
Methods: IB-IVUS using a 40-MHz (motorized pullback 0.5 mm/s) intravascular catheter was performed in 59 consecutive patients, with stable angina planned to be treated. Non-culprit intermediate plaques analyzed in this study had to be more than 5 mm apart from the intervention site. Three-dimensional analysis of IB-IVUS images was performed to determine the percentage of lipid volume (LV) and fibrous volume (FV). We also measured plasma levels of uremic toxins [indoxyl sulfate (IS), asymmetric dimethylarginine (ADMA), and p-cresol (PC)].
Results: The plasma creatinine levels correlated with levels of IS (r=0.273, p<0.05), however, did not correlate with levels of ADMA and PC (both NS, respectively). The percent LV correlated with levels of IS (r=0.365, p<0.05), however, did not correlate with levels of ADMA and PC (both NS, respectively). The percent FV also correlated with levels of IS (r=-0.356, p<0.05), however, did not correlate with levels of ADMA and PC (both NS, respectively). Multiple regression analysis revealed that only IS level predicted the percent LV (r=0.359, p<0.05) and the percent FV (r=-0.305, p<0.05) independently of potentially confounding coronary risk factors (glomerular filtration rate, triglycerides, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, fasting blood sugar, smoking, and age).
Conclusions: Among the uremic toxins, only plasma IS level was associated with coronary plaque vulnerability in patients with coronary artery disease. Our findings suggest that plasma IS level might be a new useful biomarker to detect and monitor vulnerable coronary plaque in patients with chronic renal failure.
- © 2013 by American Heart Association, Inc.