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Impacts of estimated glomerular filtration rate on coronary atherosclerosis and plaque composition before and during statin therapy in patients with normal to mild renal dysfunction: Subanalysis of the TRUTH study
Author(s) -
NOZUE TSUYOSHI,
YAMAMOTO SHINGO,
TOHYAMA SHINICHI,
FUKUI KAZUKI,
UMEZAWA SHIGEO,
ONISHI YUKO,
KUNISHIMA TOMOYUKI,
HIBI KIYOSHI,
TERASHIMA MITSUYASU,
MICHISHITA ICHIRO
Publication year - 2012
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2012.01628.x
Subject(s) - medicine , atheroma , renal function , cardiology , intravascular ultrasound , statin , coronary atherosclerosis , angina , urology , endocrinology , gastroenterology , coronary artery disease , myocardial infarction
Aim: Renal dysfunction is an independent risk factor for cardiovascular events. However, little is known regarding the impacts of renal dysfunction on coronary atherosclerosis. Methods: The effects of 8‐month statin therapy on coronary atherosclerosis were evaluated in the TRUTH study using virtual histology intravascular ultrasound in 164 patients with angina pectoris. We analyzed correlations between the estimated glomerular filtration rate (eGFR) and coronary atherosclerosis before and during statin therapy. Results: Baseline eGFR was 64.5 mL/min per 1.73 m 2 . Serum low‐density lipoprotein cholesterol level decreased significantly from 132 to 85 mg/dL (−35%, P < 0.0001) after 8 months. Weak, but significant, negative correlations were observed between eGFR and external elastic membrane volume (r = −0.228, P = 0.01) and atheroma volume (r = −0.232, P = 0.01) at baseline. The eGFR was also negatively correlated with fibro‐fatty volume (r = −0.254, P = 0.005) and fibrous volume (r = −0.241, P = 0.008) at baseline. Multivariate regression analyses showed that eGFR was a significant independent predictor associated with statin pre‐treatment volume in fibro‐fatty (β = −0.23, P = 0.01) and fibrous (β = −0.203, P = 0.02) components. Furthermore, eGFR was positively correlated with volume change in the fibro‐fatty component during statin therapy (r = 0.215, P = 0.02). Conclusion: Decreased eGFR is associated with expanding remodelling and a greater atheroma volume, particularly the fibro‐fatty and fibrous volume before statin therapy in patients with normal to mild renal dysfunction. Reduction of fibro‐fatty volume during statin therapy gradually accelerated with decreasing renal function.