Impact of chronic kidney disease stages on atherosclerotic plaque components on optical coherence tomography in patients with coronary artery disease

Abstract

The progression of coronary atherosclerosis has been influenced by the presence of chronic kidney disease (CKD). This study investigated the impact of CKD stages on coronary plaque components observed on optical coherence tomography (OCT). We investigated 296 native coronary lesions with stable angina pectoris treated with stent implantation. All lesions were divided into the three groups according to the values of estimated glomerular filtration rate (eGFR, mL min^-1 1.73 m^-2): the non-CKD group (eGFR ≥60, n = 142), CKD group (15 ≤ eGFR < 60, n = 126), and end-stage kidney disease (ESKD) group (eGFR <15 and/or hemodialysis, n = 28). Among the groups, plaque morphologies at the narrowest culprit sites on OCT were evaluated. The CKD group had a larger lipid arc [207.5 (88.3-264.5) vs. 159.3 (73.3-227.7) degrees, P = 0.037] and longer lipid length [2.4 (0.0-5.7) vs. 0.0 (0.0-4.7) mm, P = 0.017] than the non-CKD group. The ESKD group had a thinner fibrous cap [120 (70-258) vs. 170 (100-270) μm, P = 0.044], higher prevalence of plaque rupture (28.6 vs. 12.3 %, P = 0.038), and larger calcification arc [124.8 (0.0-194.3) vs. 0.0 (0.0-125.4) degrees, P = 0.025] than the non-ESKD group (CKD + non-CKD groups). The presence of CKD was related to the growth of lipidic plaques. Furthermore, the advancement in the CKD stage to ESKD affected the occurrence of plaque rupture or progression of calcification.

Keywords: Atherosclerosis; Chronic kidney disease; Coronary disease; Optical coherence tomography.