An optical coherence tomography comparison of coronary arterial plaque calcification in patients with end-stage renal disease and diabetes mellitus
| Autor: | Tomas Kovarnik, John J. Lopez, Holly J Mattix-Kramer, Nicholas Kassis, Kunal Shah, Brendan Martin, Joseph R. Weber |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty diabetes mellitus type 2 Endocrinology Diabetes and Metabolism medicine.medical_treatment Disease Coronary Artery Disease End stage renal disease Coronary artery disease calcification Optical coherence tomography Predictive Value of Tests Renal Dialysis Internal medicine Diabetes mellitus Internal Medicine medicine Humans In patient Registries Vascular Calcification Dialysis coronary artery calcium Aged Retrospective Studies end-stage renal disease medicine.diagnostic_test business.industry Middle Aged medicine.disease Plaque Atherosclerotic Diabetes Mellitus Type 2 Heart Disease Risk Factors Cardiology Kidney Failure Chronic Original Article Female atherosclerosis Cardiology and Cardiovascular Medicine business Tomography Optical Coherence Calcification |
| Zdroj: | Diabetes & Vascular Disease Research |
| ISSN: | 1752-8984 1479-1641 |
| Popis: | Background:Coronary arterial plaques in patients with end-stage renal disease (ESRD) are assumed to have increased calcification due to underlying renal disease or initiation of dialysis. This relationship may be confounded by comorbid type 2 diabetes mellitus (DM).Methods:From a single-center OCT registry, 60 patients were analyzed. Twenty patients with ESRD and diabetes (ESRD-DM) were compared to 2 groups of non-ESRD patients: 20 with and 20 without diabetes. In each patient, one 20 mm segment within the culprit vessel was analyzed.Results:ESRD-DM patients exhibited similar calcium burden, arc, and area compared to patients with diabetes alone. When compared to patients without diabetes, patients with diabetes exhibited a greater summed area of calcium (DM: Median 9.0, IQR [5.3–28] mm2vs Non-DM: 3.5 [0.1–14] mm2, p = 0.04) and larger calcium deposits by arc (DM: Mean 45 ± SE 6.2° vs Non-DM: 21 ± 6.2°, p = 0.01) and area (DM: 0.58 ± 0.10 mm2vs Non-DM: 0.26 ± 0.10 mm2, p = 0.03). Calcification deposits in ESRD-DM patients (0.14 ± 0.02 mm) and patients with diabetes (0.14 ± 0.02 mm) were more superficially located relative to patients without diabetes (0.21 ± 0.02 mm), p = 0.01 for both.Conclusions:Coronary calcification in DM and ESRD-DM groups exhibited similar burden, deposit size, and depth within the arterial wall. The increase in coronary calcification and cardiovascular disease events seen in ESRD-DM patients may not be secondary to ESRD and dialysis, but instead due to a combination of declining renal function and diabetes. |
| Databáze: | OpenAIRE |
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