Dynamic Natural Components and Morphological Changes in Nonculprit Subclinical Atherosclerosis in Patients with Acute Coronary Syndrome and Mild Chronic Kidney Disease at the 1-year Follow-up and Clinical Significance at the 5-year Follow-up

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 May 31

PMID 38820294

Authors

Jia-Cong Nong

Wei You

Yi-Fei Wang

Yi Xu

Tian Xu

Pei-Na Meng

Xiang-Qi Wu

Zhi-Ming Wu

Xiao-Han Kong

Hai-Bo Jia

De-Lu Yin

Lang Li

Fei Ye

Affiliations

Soon will be listed here.

Abstract

Introduction: The natural outcome of coronary plaque in acute coronary syndrome (ACS) patients with chronic kidney disease (CKD) is unique, which can be analyzed quantitatively by optical flow ratio (OFR) software.

Methods: A total of 184 ACS patients with at least one nonculprit subclinical atherosclerosis (NSA) detected by optical coherence tomography (OCT) at baseline and 1-year follow-up were divided into non-CKD group (n = 106, estimated glomerular filtration rate (eGFR)> 90 mL/(min×1.73 m2)) and mild CKD group (n = 78, 60≤eGFR<90 mL/(min×1.73 m2)). Changes of normalized total atheroma volume (TAVn) of NSA was the primary endpoint at the 1-year follow-up.

Results: Patients with mild CKD showed more TAVn progression of NSA than non-CKD (p = 0.019) from baseline to the 1-year follow-up, which was mainly due to an increase in calcium TAVn (p<0.001). The morphological change in the maximal calcification thickness (p = 0.026) was higher and the change in the distance from the calcified surface to the contralateral coronary media membrane (ΔC-to-M) at the maximal cross-sectional calcium area was lower (p<0.001) in mild CKD group than in non-CKD group. Mild CKD had more NSA related MACEs at the 5-year follow-up than non-CKD (30.8% vs. 5.8%, p = 0.045).

Conclusions: Mild CKD patients had more plaque progression of NSA which showed the increase of calcium component with more protrusion into the lumen morphologically at the 1-year follow-up and a higher corresponding incidence of NSA-related MACEs at the 5-year follow-up.

Trial Registration: Clinical Trial registration ClinicalTrials.gov. NCT02140801. https://classic.clinicaltrials.gov/ct2/show/NCT02140801.

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