Tohoku J. Exp. Med., 2011, 225(3)

Association between Renal Dysfunction and the Mixed Plaque of Coronary Artery on Computed Tomographic Angiography

JIYOON SUNG,¹ JAE HYUN CHANG,¹ WOOK-JIN CHUNG,¹ JI YONG JUNG,¹ SUN YOUNG NA,¹ HYUN HEE LEE,¹ YON MI SUNG,² CHAN IL MOON,¹ YOUNG-HWAN HWANG,³ WOOKYUNG CHUNG¹ and SEJOONG KIM⁴

¹Department of Internal Medicine, Gachon University School of Medicine, Incheon, Korea
²Department of Radiology, Gachon University School of Medicine, Incheon, Korea
³Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
⁴Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Coronary artery plaque is related to development of coronary artery disease (CAD), and chronic kidney disease is associated with CAD. However, the association of renal dysfunction (RD) with coronary artery plaque characteristics has not been fully elucidated. We evaluated the association between RD and coronary artery plaque characteristics in patients with suspected CAD, who underwent multislice computed tomographic angiography (CTA). A total of 918 patients were classified into 4 groups: group with no plaque (NP) (48.9%), group with calcified plaque (CP) (16.0%), group with noncalcified plaque (NCP) (22.4%), and group with mixed plaque (MP) (12.7%). NCP is considered as rupture-prone soft plaque, and CP as more stable lesion. The mean of estimated glomerular filtration rate (eGFR) was 82.5 ± 15.4 mL/min/1.73m², and the prevalence of RD (defined as eGFR < 60 mL/min/1.73m²) was 6.3%. The prevalence of RD was 3.3% in the NP group, 10.2% in the CP group, 5.3% in the NCP group, and 14.5% in the MP group (P < 0.001 by ANOVA tests). The adjusted odds ratio for RD was 3.38 (95% confidence interval, 1.27 - 9.04) for the MP group, compared with the NP group. The presence of RD showed an independent association with the MP counts (r = 0.155, P < 0.001); however, there was no association between RD and other plaque characteristics. In conclusion, RD is associated with MP rather than CP or NCP, compared with NP, which may reflect one of the developmental processes of CAD in patients with RD.

keywords —— calcified plaque; computed tomographic angiography; coronary artery plaque; mixed plaque; renal dysfunction

© 2011 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2011, 225, 171-177

Correspondence: Sejoong Kim, M.D., Ph.D., Division of Nephrology, Department of Internal Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.

e-mail: imsejoong@hanmail.net