Publication Date

2012

Journal

The Texas Heart Journal

PMID

23304018

Publication Date(s)

2012

Language

English

PMCID

PMC3528227

PubMedCentral® Posted Date

2012

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Aged, Atherosclerosis, California, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Multidetector Computed Tomography, Renal Insufficiency, Chronic, Retrospective Studies, Risk Factors, Severity of Illness Index

Abstract

Chronic kidney disease (CKD) is an independent risk factor for cardiovascular events. We evaluated whether multidetector computed tomographic angiography (MDCTA) revealed a link between pre-dialysis CKD and coronary artery atherosclerosis.

We retrospectively analyzed 549 patients who underwent MDCTA. Patients were divided into 3 groups: normal glomerular filtration rate (GFR) (GFR >90 mL/min/1.73 m2 body surface area), mild CKD (>60GFR≤90 mL/min/1.73 m2), and moderate CKD (>30GFR≤60 mL/min/1.73 m2). Normality testing was performed to determine if continuous variables were modeled in Gaussian distribution before analysis of variance was applied. The χ2 test was used to compare GFR subgroups. Multiple linear regression was used to detect associations of total plaque score (TPS), segment involvement score (SIS), and segment stenosis score (SSS) with GFR. A model adjusted for covariates was applied.

Patients with mild CKD had a mean TPS 2.3 points higher than those with a normal GFR (P=0.002); patients with moderate CKD had a mean TPS 5.9 points higher than the referent (P <0.001). Patients with mild CKD had a mean SIS 1.1 points higher than those with a normal GFR (P=0.002); patients with moderate CKD had a mean SIS 2.4 points higher than the referent (P <0.001). Patients with mild CKD had a mean SSS 1.4 points higher than those with a normal GFR (P=0.004); patients with moderate CKD had a mean SSS 4.2 points higher than the referent (P <0.001). The use of MDCTA showed that mild and moderate pre-dialysis CKD are independent risk factors for coronary artery atherosclerosis.

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