Abstract
Background
In patients with coronary artery disease (CAD), coronary plaques with high-risk features and low-attenuation plaque burden are independent measures associated with major adverse cardiovascular events (MACE). Patients with chronic kidney failure may have different CAD characteristics.
The aim was to assess the association of coronary plaque characteristics and CAD extent with MACE and all-cause mortality in patients with chronic kidney failure.
Methods
Potential kidney transplant candidates that underwent coronary computed tomography angiography (CCTA) as part of the cardiac screening program before kidney transplantation were included. We evaluated high-risk plaques and diameter stenosis semi-qualitatively; and quantified coronary artery calcium score (CACS) and plaque burden (percentage atheroma volume).
Results
In 484 patients with chronic kidney failure and few or no symptoms of CAD (mean age 53±12, 62% men, 32% on dialysis), 56 (12%) patients suffered MACE and 69 (14%) patients died during a median follow-up of 4.9 years. High-risk plaques were present in 39 (70%) patients with MACE. Median calcified plaque burden was 3.7% in patients with MACE versus 0.2% in patients without MACE. Median low-attenuation plaque burden was 0.3% versus 0.03%, respectively. In semi-qualitative analyses, the presence of high-risk plaque and higher CACS were associated with increased risk of MACE (hazard ratio (HR), 2.0 (95% CI: 1.0-3.7), p=0.040, and HR 1.2 (95% CI: 1.0-1.3), p=0.014), respectively. Neither were associated with all-cause mortality. In quantified analysis, increasing levels of both calcified and low-attenuation plaque burdens were associated with risk of MACE (HR 2.6 (95%CI: 1.8-3.7), p<0.001 and HR 2.6 (95%CI: 1.5-4.5), p=0.001 (per variable doubling, respectively)) and all-cause mortality (HR 1.6 (95%CI: 1.2-2.1), p=0.002, and HR 1.8 (95%CI: 1.1-3.0), p=0.028, respectively).
In patients with coronary artery disease (CAD), coronary plaques with high-risk features and low-attenuation plaque burden are independent measures associated with major adverse cardiovascular events (MACE). Patients with chronic kidney failure may have different CAD characteristics.
The aim was to assess the association of coronary plaque characteristics and CAD extent with MACE and all-cause mortality in patients with chronic kidney failure.
Methods
Potential kidney transplant candidates that underwent coronary computed tomography angiography (CCTA) as part of the cardiac screening program before kidney transplantation were included. We evaluated high-risk plaques and diameter stenosis semi-qualitatively; and quantified coronary artery calcium score (CACS) and plaque burden (percentage atheroma volume).
Results
In 484 patients with chronic kidney failure and few or no symptoms of CAD (mean age 53±12, 62% men, 32% on dialysis), 56 (12%) patients suffered MACE and 69 (14%) patients died during a median follow-up of 4.9 years. High-risk plaques were present in 39 (70%) patients with MACE. Median calcified plaque burden was 3.7% in patients with MACE versus 0.2% in patients without MACE. Median low-attenuation plaque burden was 0.3% versus 0.03%, respectively. In semi-qualitative analyses, the presence of high-risk plaque and higher CACS were associated with increased risk of MACE (hazard ratio (HR), 2.0 (95% CI: 1.0-3.7), p=0.040, and HR 1.2 (95% CI: 1.0-1.3), p=0.014), respectively. Neither were associated with all-cause mortality. In quantified analysis, increasing levels of both calcified and low-attenuation plaque burdens were associated with risk of MACE (HR 2.6 (95%CI: 1.8-3.7), p<0.001 and HR 2.6 (95%CI: 1.5-4.5), p=0.001 (per variable doubling, respectively)) and all-cause mortality (HR 1.6 (95%CI: 1.2-2.1), p=0.002, and HR 1.8 (95%CI: 1.1-3.0), p=0.028, respectively).
| Original language | English |
|---|---|
| Journal | Circulation: Cardiovascular Imaging |
| Volume | 17 |
| Issue number | 10 |
| Early online date | 30 Sept 2024 |
| DOIs | |
| Publication status | Published - 1 Oct 2024 |