Composition and plaque patterns of coronary culprit lesions and clinical characteristics of patients with chronic kidney disease
Open accessAbstract
Coronary artery disease is a serious complication of chronic kidney disease (CKD); however, there is little information about coronary plaque morphology in these patients. Here we identified the characteristics of coronary culprit plaques and their clinical manifestations in 78 patients with CKD divided into four groups based on their estimated glomerular filtration rate. Patients were examined by Virtual Histology-Intravascular Ultrasound, a tomographic imaging method that can visualize atherosclerotic plaques in vivo using radiofrequency analysis of ultrasound backscatter signals. These ultrasound analyses showed an increase in the relative volumes of both dense calcium and necrotic core with decreasing renal function. The necrotic core/dense calcium ratio was significantly higher in patients with acute myocardial infarction compared to those with stable angina pectoris. Furthermore, the necrotic core/dense calcium ratio decreased in advanced CKD. Thus, the plaque composition of coronary culprit lesions changed from necrotic core-rich to extensively calcium-rich plaques as renal function decreased, suggesting that such coronary culprit composition was associated with stability, particularly in advanced CKD.
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Accelerated vascular media calcification with increased vascular stiffness is a feature of chronic kidney disease and is attributed to disordered calcium-phosphate metabolism, referred to as CKD-mineral bone disorder.
“Accelerated vascular media calcification with increased vascular stiffness is also a feature of CKD and attributed to disordered calcium-phosphate metabolism, referred to as CKD-mineral bone disorder (CKD-MBD). 690,691”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [691]
Lowering phosphate, controlling parathyroid hormone, and maintaining normal calcium levels is common practice in nephrology despite a lack of definitive evidence that it modifies risk of CVD.
“Lowering phosphate, controlling parathyroid hormone, and maintaining normal calcium levels is common practice in nephrology despite a lack of definitive evidence that it modifies risk of CVD.691,741”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [691]
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Self-citationA Saudi Heart Association Position Statement on Cardiovascular Diseases and Diabetes Mellitus
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Revascularization Strategies in Patients with Chronic Kidney Disease and Acute Coronary Syndromes
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Niereninsuffizienz und kardiovaskuläres Risiko
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2. Singularity of Coronary Artery Disease in Chronic Kidney Disease
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Self-citation16. The Control of Cardiovascular Diseases of the Patients with Chronic Kidney Disease
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- Authors
- Kono, K., Fujii, H., Nakai, K., Goto, S., Shite, J., Hirata, K.-I., Fukagawa, M., & Nishi, S.
- Affiliations
- Kobe University (JP)
- Tokai University (JP)
- Corresponding author
- Fujii, Hideki
- ORCID
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 82
- Issue
- 3
- Pages
- 344-351
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W2076880163
- Cited by
- 66
- References
- 42
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 7 · 2018: 2 · 2017: 8 · 2016: 12 · 2015: 8 · 2014: 2 · 2013: 4 · 2012: 2
- FWCI
- 5.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- chronic kidney disease, coronary artery disease, coronary plaque composition, necrotic core, dense calcium, plaque stability, acute myocardial infarction, stable angina, estimated glomerular filtration rate, virtual histology intravascular ultrasound
- MeSH terms
- Aged, Aged, 80 and over, Angina Pectoris, Coronary Artery Disease, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Myocardial Infarction, Necrosis, Risk Factors, Ultrasonography, Renal Insufficiency, Chronic, Plaque, Atherosclerotic, Vascular Calcification
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