IMPACT OF DIABETIC KIDNEY DISEASE ON CORONARY ARTERY PLAQUE PROGRESSION

Abstract BACKGROUND AND AIMS The aim of this study was to evaluate the relationship between diabetic kidney disease (DKD) and change in coronary plaque volume in asymptomatic diabetes patients. METHOD In this prospective observational study, we analyzed 79 asymptomatic type 2 diabetes patients (age, 63.7 ± 8.1 years; male, 69.3%) without prior history of coronary artery disease who underwent serial 320-row computed tomography coronary angiography with an interscan interval of more than 24 months (median 37.7 months). Total coronary plaque volume was assessed at baseline and after 3 years, using QAngio CT (MEDIS) for vessel diameters greater than 1.5 mm in the three main branches. The primary endpoint was coronary plaque progression (PP), which was defined as the absolute change in coronary plaque volume during the 3 years. PP was compared among four groups, which were divided according to the presence or absence of DKD at baseline and after 3 years, as follows: Group 1 (no DKD at baseline, no DKD after 3 years), Group 2 (DKD at baseline, no DKD after 3 years), Group 3 (no DKD at baseline, DKD after 3 years), Group 4 (DKD at baseline, DKD after 3 years)]. DKD was defined as albuminuria >30 mg/g Cr or eGFR <60 mL/min/1.73 m2. We conducted univariate linear regression analysis to assess the association of DKD groups with PP. RESULTS Plaque volumes were significantly greater in Group 4 than in Group 1 both at baseline and after 3 years (Table 1). PP was also significantly greater in Group 4 than in Group 1 (β-coefficient: 293.6, P < 0.01). Group 4 had greater PP compared with Group 1 after adjustment (β-coefficient: 181.6, P < 0.05). CONCLUSION DKD may be an independent risk factor for coronary plaque progression in asymptomatic type 2 diabetic patients without a history of cardiovascular disease. Early therapeutic intervention in such patients may prevent the onset of coronary artery disease.