nach oben

Erschienen in:

03.01.2019 | Original Article

Influence of chronic kidney disease on coronary plaque components in coronary artery disease patients with both diabetes mellitus and hypertension

verfasst von: Eiji Shigemoto, Atsushi Iwata, Makito Futami, Yuta Kato, Motoki Yamashita, Satoshi Imaizumi, Takashi Kuwano, Amane Ike, Makoto Sugihara, Keijiro Saku, Shin-ichiro Miura

Erschienen in: Heart and Vessels | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Chronic kidney disease (CKD) is well known to be associated with an increased incidence of coronary artery disease (CAD). Diabetes mellitus (DM) and hypertension (HTN), both of which are traditional risk factors for CAD, are the two most common causes of CKD. However, the influence of CKD on coronary atherosclerosis in CAD patients who have both DM and HTN remains uncertain. In these patients, we examined the relationship between CKD and coronary plaque using integrated backscatter intravascular ultrasound (IB IVUS). Two hundred two CAD patients with both DM and HTN who underwent percutaneous coronary intervention using IB IVUS were included. The patients were divided into two groups: CKD group (n = 106) and non-CKD group (n = 96). Gray-scale and IB IVUS examinations were conducted for the non-culprit segment of a coronary artery. As a result, although there was no significant difference in the percentage of plaque volume, the percentage of lipid volume was significantly higher in the CKD group than in the non-CKD group [median (IQR): 56.7% (45.4–67.0%) vs. 52.0% (38.3–60.2%), p = 0.03]. In all of the patients, estimated glomerular filtration rate levels were negatively correlated with the percentage of lipid volume (r = − 0.15, p = 0.03) and positively correlated with the percentage of fibrosis volume (r = 0.15, p = 0.04). A multivariate regression analysis showed that CKD was an independent predictor associated with the increased lipid volume (β = 0.15, p = 0.047) and decreased fibrosis volume (β = − 0.16, p = 0.03) in coronary plaques. In conclusion, among CAD patients who had both DM and HTN, CKD was associated with lipid-rich coronary plaques. CKD may contribute to the vulnerability of coronary plaque in these very high-risk patients.

Hu JR, Coresh J (2017) The public health dimension of chronic kidney disease: what we have learnt over the past decade. Nephrol Dial Transplant 32:ii113–ii120CrossRefPubMed

Drawz P, Rahman M (2015) Chronic kidney disease. Ann Intern Med 162:Itc1–Itc16CrossRefPubMed

Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AY, Yang CW (2013) Chronic kidney disease: global dimension and perspectives. Lancet 382:260–272CrossRefPubMed

Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296–1305CrossRefPubMed

Afkarian M, Sachs MC, Kestenbaum B, Hirsch IB, Tuttle KR, Himmelfarb J, de Boer IH (2013) Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol 24:302–308CrossRefPubMedPubMedCentral

Rahman M, Pressel S, Davis BR, Nwachuku C, Wright JT Jr, Whelton PK, Barzilay J, Batuman V, Eckfeldt JH, Farber MA, Franklin S, Henriquez M, Kopyt N, Louis GT, Saklayen M, Stanford C, Walworth C, Ward H, Wiegmann T (2006) Cardiovascular outcomes in high-risk hypertensive patients stratified by baseline glomerular filtration rate. Ann Intern Med 144:172–180CrossRefPubMed

Mintz GS, Nissen SE, Anderson WD, Bailey SR, Erbel R, Fitzgerald PJ, Pinto FJ, Rosenfield K, Siegel RJ, Tuzcu EM, Yock PG (2001) American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 37:1478–1492CrossRefPubMed

Kawasaki M, Takatsu H, Noda T, Sano K, Ito Y, Hayakawa K, Tsuchiya K, Arai M, Nishigaki K, Takemura G, Minatoguchi S, Fujiwara T, Fujiwara H (2002) In vivo quantitative tissue characterization of human coronary arterial plaques by use of integrated backscatter intravascular ultrasound and comparison with angioscopic findings. Circulation 105:2487–2492CrossRefPubMed

Sano K, Kawasaki M, Ishihara Y, Okubo M, Tsuchiya K, Nishigaki K, Zhou X, Minatoguchi S, Fujita H, Fujiwara H (2006) Assessment of vulnerable plaques causing acute coronary syndrome using integrated backscatter intravascular ultrasound. J Am Coll Cardiol 47:734–741CrossRefPubMed

10.

Amano T, Matsubara T, Uetani T, Kato M, Kato B, Yoshida T, Harada K, Kumagai S, Kunimura A, Shinbo Y, Ishii H, Murohara T (2011) Lipid-rich plaques predict non-target-lesion ischemic events in patients undergoing percutaneous coronary intervention. Circ J 75:157–166CrossRefPubMed

11.

Hayano S, Ichimiya S, Ishii H, Kanashiro M, Watanabe J, Kurebayashi N, Yoshikawa D, Amano T, Matsubara T, Murohara T (2012) Relation between estimated glomerular filtration rate and composition of coronary arterial atherosclerotic plaques. Am J Cardiol 109:1131–1136CrossRefPubMed

12.

Ogita M, Funayama H, Nakamura T, Sakakura K, Sugawara Y, Kubo N, Ako J, Ishikawa SE, Momomura S (2009) Plaque characterization of non-culprit lesions by virtual histology intravascular ultrasound in diabetic patients: impact of renal function. J Cardiol 54:59–65CrossRefPubMed

13.

Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, Araki E, Ito C, Inagaki N, Iwamoto Y, Kasuga M, Hanafusa T, Haneda M, Ueki K (2010) Report of the committee on the classification and diagnostic criteria of diabetes mellitus. J Diabetes Investig 1:212–228CrossRefPubMedPubMedCentral

14.

Oparil S (2014) Updated guidelines for management of high blood pressure in Japan. Hypertens Res 37:484–487CrossRefPubMed

15.

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in Renal Disease Study Group. Ann Intern Med 130:461–470CrossRefPubMed

16.

JCS Joint Working Group (2013) Guidelines for secondary prevention of myocardial infarction (JCS 2011). Circ J 77:231–248CrossRef

17.

Maejima N, Hibi K, Saka K, Nakayama N, Matsuzawa Y, Endo M, Iwahashi N, Okuda J, Tsukahara K, Tahara Y, Kosuge M, Ebina T, Umemura S, Kimura K (2015) Morphological features of non-culprit plaques on optical coherence tomography and integrated backscatter intravascular ultrasound in patients with acute coronary syndromes. Eur Heart J Cardiovasc Imaging 16:190–197CrossRefPubMed

18.

Mitsuhashi T, Hibi K, Kosuge M, Morita S, Komura N, Kusama I, Otsuka F, Endo M, Iwahashi N, Okuda J, Tsukahara K, Ebina T, Umemura S, Kimura K (2011) Relation between hyperinsulinemia and nonculprit plaque characteristics in nondiabetic patients with acute coronary syndromes. JACC Cardiovasc Imaging 4:392–401CrossRefPubMed

19.

Nakayama N, Hibi K, Endo M, Miyazawa A, Suzuki H, Maejima N, Isshiki T, Kozuma K, Kimura K (2013) Validity and reliability of new intravascular ultrasound analysis software for morphological measurement of coronary artery disease. Circ J 77:424–431CrossRefPubMed

20.

Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440–1463CrossRefPubMed

21.

Nakayama M, Sato T, Miyazaki M, Matsushima M, Sato H, Taguma Y, Ito S (2011) Increased risk of cardiovascular events and mortality among non-diabetic chronic kidney disease patients with hypertensive nephropathy: the Gonryo study. Hypertens Res 34:1106–1110CrossRefPubMed

22.

Dzau VJ, Antman EM, Black HR, Hayes DL, Manson JE, Plutzky J, Popma JJ, Stevenson W (2006) The cardiovascular disease continuum validated: clinical evidence of improved patient outcomes: part I: Pathophysiology and clinical trial evidence (risk factors through stable coronary artery disease). Circulation 114:2850–2870CrossRefPubMed

23.

De Vriese AS, Verbeuren TJ, Van de Voorde J, Lameire NH, Vanhoutte PM (2000) Endothelial dysfunction in diabetes. Br J Pharmacol 130:963–974CrossRefPubMedPubMedCentral

24.

Dinh QN, Drummond GR, Sobey CG, Chrissobolis S (2014) Roles of inflammation, oxidative stress, and vascular dysfunction in hypertension. Biomed Res Int 2014:406960CrossRefPubMedPubMedCentral

25.

Haugen E, Nath KA (1999) The involvement of oxidative stress in the progression of renal injury. Blood Purif 17:58–65CrossRefPubMed

26.

Moody WE, Edwards NC, Madhani M, Chue CD, Steeds RP, Ferro CJ, Townend JN (2012) Endothelial dysfunction and cardiovascular disease in early-stage chronic kidney disease: cause or association? Atherosclerosis 223:86–94CrossRefPubMed

27.

Hirata Y, Sugiyama S, Yamamoto E, Matsuzawa Y, Akiyama E, Kusaka H, Fujisue K, Kurokawa H, Matsubara J, Sugamura K, Maeda H, Iwashita S, Jinnouchi H, Matsui K, Ogawa H (2014) Endothelial function and cardiovascular events in chronic kidney disease. Int J Cardiol 173:481–486CrossRefPubMed

28.

Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali C (2003) Oxidative stress in end-stage renal disease: an emerging threat to patient outcome. Nephrol Dial Transplant 18:1272–1280CrossRefPubMed

29.

Vaziri ND (2014) Role of dyslipidemia in impairment of energy metabolism, oxidative stress, inflammation and cardiovascular disease in chronic kidney disease. Clin Exp Nephrol 18:265–268CrossRefPubMed

30.

Bulbul MC, Dagel T, Afsar B, Ulusu NN, Kuwabara M, Covic A, Kanbay M (2018) Disorders of lipid metabolism in chronic kidney disease. Blood Purif 46:144–152CrossRefPubMed

31.

Fujioka Y, Ishikawa Y (2009) Remnant lipoproteins as strong key particles to atherogenesis. J Atheroscler Thromb 16:145–154CrossRefPubMed

32.

Vaziri ND (2006) Dyslipidemia of chronic renal failure: the nature, mechanisms, and potential consequences. Am J Physiol Renal Physiol 290:F262–F272CrossRefPubMed

33.

Cho Y, Lee SG, Jee SH, Kim JH (2015) Hypertriglyceridemia is a major factor associated with elevated levels of small dense LDL cholesterol in patients with metabolic syndrome. Ann Lab Med 35:586–594CrossRefPubMedPubMedCentral

34.

Rohatgi A, Khera A, Berry JD, Givens EG, Ayers CR, Wedin KE, Neeland IJ, Yuhanna IS, Rader DR, de Lemos JA, Shaul PW (2014) HDL cholesterol efflux capacity and incident cardiovascular events. N Engl J Med 371:2383–2393CrossRefPubMedPubMedCentral

35.

Patel PJ, Khera AV, Jafri K, Wilensky RL, Rader DJ (2011) The anti-oxidative capacity of high-density lipoprotein is reduced in acute coronary syndrome but not in stable coronary artery disease. J Am Coll Cardiol 58:2068–2075CrossRefPubMed

36.

Nakano T, Ninomiya T, Sumiyoshi S, Fujii H, Doi Y, Hirakata H, Tsuruya K, Iida M, Kiyohara Y, Sueishi K (2010) Association of kidney function with coronary atherosclerosis and calcification in autopsy samples from Japanese elders: the Hisayama study. Am J Kidney Dis 55:21–30CrossRefPubMed

37.

Kashiyama K, Sonoda S, Muraoka Y, Suzuki Y, Kamezaki F, Tsuda Y, Araki M, Tamura M, Takeuchi M, Abe H, Okazaki M, Fujino Y, Otsuji Y (2015) Coronary plaque progression of non-culprit lesions after culprit percutaneous coronary intervention in patients with moderate to advanced chronic kidney disease: intravascular ultrasound and integrated backscatter intravascular ultrasound study. Int J Cardiovasc Imaging 31:935–945CrossRefPubMedPubMedCentral

38.

Miyagi M, Ishii H, Murakami R, Isobe S, Hayashi M, Amano T, Arai K, Yoshikawa D, Ohashi T, Uetani T, Yasuda Y, Matsuo S, Matsubara T, Murohara T (2010) Impact of renal function on coronary plaque composition. Nephrol Dial Transplant 25:175–181CrossRefPubMed

39.

Kakuta K, Dohi K, Miyoshi M, Yamanaka T, Kawamura M, Masuda J, Kurita T, Ogura T, Yamada N, Sumida Y, Ito M (2017) Impact of renal function on the underlying pathophysiology of coronary plaque composition in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 16:131CrossRefPubMedPubMedCentral

40.

McCullough PA, Jurkovitz CT, Pergola PE, McGill JB, Brown WW, Collins AJ, Chen SC, Li S, Singh A, Norris KC, Klag MJ, Bakris GL (2007) Independent components of chronic kidney disease as a cardiovascular risk state: results from the Kidney Early Evaluation Program (KEEP). Arch Intern Med 167:1122–1129CrossRefPubMed

41.

van der Zee S, Baber U, Elmariah S, Winston J, Fuster V (2009) Cardiovascular risk factors in patients with chronic kidney disease. Nat Rev Cardiol 6:580–589CrossRefPubMed

42.

Kahn MR, Robbins MJ, Kim MC, Fuster V (2013) Management of cardiovascular disease in patients with kidney disease. Nat Rev Cardiol 10:261–273CrossRefPubMed

43.

Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, Coresh J, Gansevoort RT (2010) Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet 375:2073–2081CrossRefPubMedPubMedCentral

44.

Li MF, Tu YF, Li LX, Lu JX, Dong XH, Yu LB, Zhang R, Bao YQ, Jia WP, Hu RM (2013) Low-grade albuminuria is associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes. Cardiovasc Diabetol 12:110CrossRefPubMedPubMedCentral

45.

Shimbo Y, Suzuki S, Ishii H, Shibata Y, Tatami Y, Harata S, Osugi N, Ota T, Tanaka A, Shibata K, Mizukoshi T, Yasuda Y, Maruyama S, Murohara T (2015) Association of estimated glomerular filtration rate and proteinuria with lipid-rich plaque in coronary artery disease. Circ J 79:2263–2270CrossRefPubMed

46.

Okada K, Hibi K, Gohbara M, Kataoka S, Takano K, Akiyama E, Matsuzawa Y, Saka K, Maejima N, Endo M, Iwahashi N, Tsukahara K, Kosuge M, Ebina T, Fitzgerald PJ, Honda Y, Umemura S, Kimura K (2015) Association between blood glucose variability and coronary plaque instability in patients with acute coronary syndromes. Cardiovasc Diabetol 14:111CrossRefPubMedPubMedCentral

47.

Kuroda M, Shinke T, Sakaguchi K, Otake H, Takaya T, Hirota Y, Sugiyama D, Nakagawa M, Hariki H, Inoue T, Osue T, Taniguchi Y, Iwasaki M, Nishio R, Kinutani H, Konishi A, Hiranuma N, Takahashi H, Terashita D, Hirata KI (2015) Effect of daily glucose fluctuation on coronary plaque vulnerability in patients pre-treated with lipid-lowering therapy: a prospective observational study. JACC Cardiovasc Interv 8:800–811CrossRefPubMed

48.

Kume T, Akasaka T, Kawamoto T, Okura H, Watanabe N, Toyota E, Neishi Y, Sukmawan R, Sadahira Y, Yoshida K (2006) Measurement of the thickness of the fibrous cap by optical coherence tomography. Am Heart J 152:755.e751–755.e754CrossRef

49.

Jang IK, Tearney GJ, MacNeill B, Takano M, Moselewski F, Iftima N, Shishkov M, Houser S, Aretz HT, Halpern EF, Bouma BE (2005) In vivo characterization of coronary atherosclerotic plaque by use of optical coherence tomography. Circulation 111:1551–1555CrossRefPubMedPubMedCentral

Titel: Influence of chronic kidney disease on coronary plaque components in coronary artery disease patients with both diabetes mellitus and hypertension
verfasst von: Eiji Shigemoto
Atsushi Iwata
Makito Futami
Yuta Kato
Motoki Yamashita
Satoshi Imaizumi
Takashi Kuwano
Amane Ike
Makoto Sugihara
Keijiro Saku
Shin-ichiro Miura
Publikationsdatum: 03.01.2019
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 7/2019
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-018-01334-5

Neu im Fachgebiet Kardiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2019

MicroRNA-19b-1 reverses ischaemia-induced heart failure by inhibiting cardiomyocyte apoptosis and targeting Bcl2 l11/BIM

Relationship between electrical conduction and phasic left atrial function: P-wave signal-averaged electrocardiography and time-left atrial volume curve assessments using two-dimensional speckle-tracking echocardiography

Validation of wearable textile electrodes for ECG monitoring

Can we rely on Danish? Real-world data on patients with nonischemic cardiomyopathy from the German Device Registry