Abstract 15635: Creatinine Clearance Was a Superior Predictor for Atherothrombotic Stroke to Estimated Glomerular Filtration Rate
Introduction: Kidney dysfunction is a risk factor for cardiovascular diseases as well as end stage renal disease. Estimated glomerular filtration rate (eGFR) is a well-established marker for kidney function. However, eGFR is often inaccurate since it is affected by several factors such as age, gender, and muscle mass. Therefore, creatinine clearance (CCr) estimated by Cockcroft-Gault Equation is sometimes recommended especially for elderly patients.
Hypothesis: We hypothesized that kidney dysfunction evaluated by CCr is more closely associated with formation of aortic arch plaque compared to eGFR.
Methods: We enrolled 644 patients (447 males, 64.4 ± 12.3 years) who underwent transesophageal echocardiography and carotid ultrasonography, and measured eGFR and CCr. We defined aortic arch plaque as wall thickness 4 mm or more and/or the presence of ulceration or mobile plaque in aortic arch. We determined the patients with aortic arch plaque and/or atherothrombotic stroke as high-risk patients for atherothrombotic stroke.
Results: There were 139 patients with aortic arch plaque and 102 patients with history of atherothrombotic stroke. As a result, there were 158 high-risk patients. The high-risk patients were older and had higher prevalence of hypertension, diabetes, dyslipidemia, and smoking history and lower prevalence of atrial fibrillation compared with low-risk patients. CCr and eGFR were significantly lower in high-risk patients than in low-risk patients. Arch wall thickness and carotid plaque score were higher in high-risk patients compared with low-risk patients. CCr showed a greater correlation with arch wall thickness compared with eGFR. The prevalence of aortic arch plaque and/or atherothrombotic stroke was increased with advancing kidney dysfunction. In multivariate analysis, CCr was an independent predictor for high risk atherothrombotic plaque. In receiver operating characteristic analysis, the area under the curve of CCR was larger than eGFR (AUC 0.759 vs. 0.688).
Conclusions: Aortic arch plaque was deteriorated with advancing kidney dysfunction. CCr was a superior predictor for atherothrombotic stroke to eGFR.
Author Disclosures: S. Nishiyama: None. T. Watanabe: None. N. Hashimoto: None. G. Yamaura: None. M. Wanezaki: None. H. Tamura: None. H. Takahashi: None. T. Arimoto: None. T. Shishido: None. T. Yamanaka: None. T. Miyamoto: None. I. Kubota: None.
- © 2016 by American Heart Association, Inc.