Unstable Carotid Plaque as a Phenotype of Chronic Systemic Inflammation Enhances Renal Insufficiency
| Autor: | Naoki Akioka, Satoshi Kuroda, Hisayasu Saito, Kunitaka Maruyama, Shusuke Yamamoto, Daina Kashiwazaki, Naoya Kuwayama, Kyo Noguchi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Renal function Inflammation Carotid endarterectomy Kidney Systemic inflammation Risk Assessment 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine medicine Humans Carotid Stenosis Prospective Studies Renal Insufficiency Chronic Aged Endarterectomy Carotid Rupture Spontaneous business.industry Endovascular Procedures Rehabilitation Odds ratio medicine.disease Plaque Atherosclerotic Confidence interval Stenosis Diffusion Magnetic Resonance Imaging Phenotype Chronic Disease Cardiology Female Stents Surgery Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Glomerular Filtration Rate Kidney disease |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 29:104698 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2020.104698 |
| Popis: | Purpose: Chronic systemic inflammation is prevalent in patients with chronic kidney disease (CKD) and is linked to the development of cerebrovascular disease. In this study, we explored the association between the unstable plaques and preoperative CKD in patients who underwent carotid endarterectomy (CEA)/carotid artery stenting (CAS). Furthermore, this study also aimed to explore whether there is a difference in the aggravation of renal function with the presence of stable or unstable plaques. Patients and Methods: The study included 90 patients who underwent CEA/CAS for carotid artery stenosis. Multivariate analysis was performed to determine the risk factors for CKD. Kaplan-Meier estimation was employed to evaluate the aggravation of renal function following CEA/CAS. Results: Multivariate analysis revealed that contralateral carotid occlusive disease (odds ratio [OR], 4.45; 95% confidence interval [CI], 1.36-14.6), and T1 high-intensity carotid plaque (OR, 3.26; 95% CI, 1.2-8.86) were independent factors of CKD. Kaplan-Meier estimation demonstrated a higher aggravation of renal function in the T1 high-intensity group compared to those in the iso-intensity (P =.03). Following CEA/CAS, the time until aggravation of renal insufficiency was 12.0 ± 9.4 months in the T1 high-intensity group and 24.5 ± 9.6 months in the iso-intensity group (P =.03). Conclusions: This study demonstrated that contralateral carotid artery stenosis and T1 high-intensity plaques are more frequently observed in patients with CKD. T1 high-intensity carotid plaque is well linked to CKD development in future. |
| Databáze: | OpenAIRE |
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