A 5-Year Follow-Up Study of 100 Patients with 118 Intermediate Coronary Artery Lesions Evaluated by Fractional Flow Reserve and Intravascular Imaging Stratified According to Renal Function

Background:Progression of chronic coronary syndrome (CCS) is influenced by chronic kidney disease (CKD).This 5-year follow-up study aimed to assess 100 patients with 118 intermediate coronary artery lesions evaluated by fractional flow reserve (FFR) and intravascular imaging stratified according to renal function. Material/Methods:This prospective study enrolled patients with intermediate coronary stenosis identified by coronary angiogram.Patients with severe renal dysfunction (estimated glomerular filtration rate (eGFR) <45 ml/min/1.73m 2 ) were excluded from the study.The remaining were divided into 2 groups according to eGFR: 45-60 ml/min/1.73m 2 for mild-to-moderate renal dysfunction and >60 ml/min/1.73m 2 for no renal dysfunction.We analyzed intermediate-grade stenoses (40-80% as assessed in coronary angiography) with the use of optical coherence tomography (OCT), FFR, and intravascular ultrasound (IVUS). Results:Renal dysfunction patients were older (67.7±8.1 vs 63.6±9.7 years, P=0.044).Lesion characteristics, including plaque type and minimal lumen area in OCT, showed no significant differences between the renal dysfunction and no renal dysfunction groups.Thin-cap fibroatheroma, calcific plaques, lipidic plaques, and fibrous plaques had similar prevalence.FFR values and IVUS parameters did not significantly differ between the groups.Over a 5-year follow-up, individuals with mild-to-moderate renal dysfunction had an elevated risk of all-cause mortality and major adverse cardiovascular events in multivariate analyses adjusted for age and sex. Conclusions:Mild-to-moderate renal dysfunction was not associated with significant differences in OCT-and IVUS-derived plaque morphology nor with functional indices characterizing intermediate-grade coronary stenoses.Renal dysfunction was related to a higher risk of all-cause mortality and major adverse cardiovascular events prevalence in 5-year follow-up.