Abstract 345: Associations Between Kidney Dysfunction and the Severity of Coronary and Aortic Atherosclerosis

Chronic kidney disease (CKD) is considered to be associated with increased risk of coronary artery disease (CAD). To elucidate the associations between kidney dysfunction (KD) and the severity of coronary and aortic atherosclerosis, we performed aortic black-blood MRI in 149 patients (pts) (age 64±9 yrs) undergoing coronary angiography. Regarding MRI, 9 slices of thoracic and 9 slices of abdominal aorta were obtained at 12-mm intervals. Plaque extent in each slice was scored. Severity of aortic atherosclerosis was represented as the sum of scores. On coronary angiograms, severity of coronary atherosclerosis was represented as the numbers of stenotic vessels and segments. KD was evaluated by eGFR. RESULTS: The 149 pts were divided into tertiles by eGFR: 51±10 (T1), 60±3 (T2) and 86±12 ml/min/1.73 2 (T3). CKD (eGFR<60) was present in 41 (28%) pts. CAD (>50% stenosis) and thoracic and abdominal aortic plaques were found in 105 (70%), 95 (64%) and 136 (91%) pts, respectively. Regarding coronary atherosclerosis, the number of >25% stenotic coronary segments correlated with eGFR (r=-0.25, P<0.005). Stepwise decrease in the number of >50% stenotic vessels was found depending on eGFR tertiles: 1.5±1.0 (T1), 1.3±1.2 (T2) and 0.9±0.8 (T3) (P<0.025). In multivariate analysis, reduced eGFR was associated with the severity of coronary atherosclerosis independent of risk factors. Regarding aortic atherosclerosis, the severity of thoracic aortic atherosclerosis correlated with eGFR (r=-0.22, P<0.01), but abdominal aortic atherosclerosis did not (P=NS). The severity of thoracic aortic atherosclerosis decreased stepwise with eGFR tertiles: 3.0 (median) (T1), 2.0 (T2) and 1.0 (T3) (P<0.02), whereas the severity of abdominal atherosclerosis tended to decrease on eGFR tertiles: 8.0 (T1), 7.0 (T2) and 6.0 (T3) (P=NS). However, in multivariate analysis, reduced eGFR was not an independent factor for thoracic or abdominal aortic atherosclerosis. CONCLUSION: The severity of coronary and thoracic, but not abdominal, aortic atherosclerosis correlated with the degree of KD. However, KD was an independent factor for coronary atherosclerosis but not for aortic atherosclerosis. KD is more likely to be associated with coronary atherosclerosis than aortic atherosclerosis.