Coronary atherosclerosis and risk of acute coronary syndromes in chronic kidney disease using angioscopy and the kidney disease: Improving Global Outcomes (KDIGO) classification

• Published in: Atherosclerosis 2015-12, Vol.243 (2), p.567-572
• Main Authors: Kurihara, Osamu, Okamatsu, Kentaro, Mizuno, Kyoichi, Takano, Masamichi, Yamamoto, Masanori, Kobayashi, Nobuaki, Munakata, Ryo, Murakami, Daisuke, Inami, Shigenobu, Ohba, Takayoshi, Hata, Noritake, Seino, Yoshihiko, Shimizu, Wataru
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - etiology; Acute Coronary Syndrome - mortality; Acute coronary syndromes; Aged; Angioscopy; Atherosclerosis; Cardiovascular; Chronic kidney disease; Coronary Artery Disease - complications; Coronary Artery Disease - mortality; Coronary Artery Disease - pathology; Coronary Vessels - pathology; Databases, Factual; Disease Progression; Female; Humans; Incidence; Japan; Kaplan-Meier Estimate; Male; Middle Aged; Plaque, Atherosclerotic; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - mortality; Retrospective Studies; Risk Assessment; Risk Factors; Rupture, Spontaneous; Time Factors
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2015.10.094

Abstract Objective This 8-year follow-up cohort study evaluated and compared the degree of coronary atherosclerosis in chronic kidney disease (CKD) according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification using multivessel angioscopy and investigated the impact of the vulnerability of coronary arteries on the relationship between the classification and risk of acute coronary syndromes (ACS). Methods We studied 89 coronary artery disease patients who underwent angioscopic observation of multiple coronary arteries. The patients were divided into 3 groups: Risk 0, 1, and 2 were equivalent to low risk, moderately high risk, and high and severely high risk, respectively. We examined the frequencies of complex and yellow plaques. Furthermore, we followed all patients for de novo ACS, dividing into two groups according to the existence of vulnerable coronary atherosclerosis (VCA) based on angioscopic findings. Results The number of yellow plaques per vessel, maximum yellow grade, number of complex plaques per vessel, and cumulative incidence of ACS in all patients were significantly associated with Risk grade progression (p