Abstract 12507: Impact of Renal Dysfunction on Changes of Plaque Characteristics in Non-Intervened Coronary Segments in Statin-Treated Patients With Angina Pectoris and Hypertension
Introduction: Chronic kidney disease (CKD) is associated with poor outcomes and increased prevalence of coronary artery disease, and accelerated atherosclerosis is a major risk to long-term survivors on maintenance hemodialysis. Hypertension promotes atherosclerosis via vascular inflammation mediated by various mediators. Previous studies have demonstrated the effects of statin therapy on regression of coronary atherosclerosis.
Hypothesis: However, few data are available about the relation between renal function and plaque changes in statin-treated patients with angina pectoris and hypertension. Therefore, the aim of this study was to assess the impact of baseline renal function on progression and compositional changes of plaque in non-intervened coronary segments in patients with angina pectoris and hypertension who used statins using virtual histology-intravascular ultrasound (VH-IVUS).
Methods: We assessed plaque changes between patients with CKD [n=81, estimated creatinine clearance (CrCl) <60 mL/min) and those without CKD (n=117) who underwent baseline and follow-up VH-IVUS for non-intervened intermediate coronary artery stenosis.
Results: Necrotic core (NC) area at minimum lumen area (MLA) site (22.5±11.7% vs. 19.0±11.1%, p=0.035) and %NC volume (20.3±8.0% vs. 15.8±9.4%, p=0.001) were significantly greater, and thin-cap fibroatheroma was observed more frequently (25.9% vs. 10.3%, p=0.004) in CKD group compared with non-CKD group. Follow-up VH-IVUS was performed in about 9 months after baseline VH-IVUS examinations. At follow-up, plaque progressed in CKD group, in contrast plaque regressed in non-CKD group [Δplaque plus media (P&M) area at MLA site: +0.41±0.72 mm2 vs. -0.78±0.64 mm2, p<0.001). The CrCl correlated with ΔP&M area at MLA site (r=-0.538, p<0.001) and Δ%NC area at MLA site (r=-0.167, p=0.019). CrCl (OR 0.901, 95% CI 0.867-0.936, p<0.001) and baseline %NC area at MLA site (OR 1.251, 95% CI 1.116-1.403, p<0.001) were the independent predictors of plaque progression at follow-up.
Conclusions: In patients with angina pectoris and hypertension who uses statins, renal dysfunction is associated with plaque progression and increase of NC component at follow-up.
Author Disclosures: Y. Hong: None. M. Jeong: None. K. Kim: None. M. Kim: None. W. Kim: None. C. Kim: None. K. Lee: None. S. Jun: None. K. Cho: None. S. Kim: None. H. Kim: None. S. Rhew: None. H. Jeong: None. J. Cho: None. K. Lee: None. K. Park: None. D. Sim: None. K. Kim: None. H. Park: None. J. Kim: None. Y. Ahn: None. J. Cho: None. J. Park: None.
- © 2014 by American Heart Association, Inc.