Key result
Reduced renal function (eGFR) showed no significant association with vulnerable carotid plaque characteristics compared to normal renal function.
Why the study?
Chronic kidney disease increases cardiovascular risk, but it remains unclear whether decreased renal function is associated with a vulnerable atherosclerotic plaque phenotype.
Does reduced renal function associate with increased carotid plaque vulnerability in patients undergoing carotid surgery?
Cohort
Does reduced renal function associate with increased carotid plaque vulnerability in patients undergoing carotid surgery?
The increased risk of stroke in patients with chronic kidney disease does not appear to be mediated by increased carotid plaque vulnerability.
No association between reduced eGFR and vulnerable carotid plaques; leaves open alternative mechanisms for CKD-related stroke risk.
BACKGROUND: Chronic Kidney Disease (CKD) is associated with an increased risk for cardiovascular events such as stroke. However, it is still unclear if decreased kidney function is associated with a vulnerable atherosclerotic plaque phenotype. To explore if renal function was associated with carotid plaque vulnerability we analyzed carotid plaques obtained at surgery from the Carotid Plaque Imaging Project (CPIP). METHODS: Patients were enrolled through the CPIP cohort. The indication for surgery was plaques with stenosis >70%, associated with ipsilateral symptoms or plaques with stenosis >80% not associated with symptoms. Transversal sections from the most stenotic plaque region were analyzed for connective tissue, calcium, lipids, macrophages, intraplaque hemorrhage, and smooth muscle cells. Homogenates were analyzed for collagen and elastin. RESULTS: . Plaque characteristics showed no significant association with eGFR, neither when eGFR was divided in CKD groups nor when eGFR was handled as a continuous variable and adjusting for other known risk factors (ie, age, diabetes, hypertension, and smoking). CONCLUSIONS: The higher risk of cardiovascular disease such as stroke in CKD is not associated with increased plaque vulnerability and other factors have to be sought.
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Heijl et al. (2020) conducted a cohort in Carotid plaques. Reduced renal function (eGFR) vs. Normal renal function was evaluated on Carotid plaque characteristics (connective tissue, calcium, lipids, macrophages, intraplaque hemorrhage, smooth muscle cells). Reduced renal function (eGFR) showed no significant association with vulnerable carotid plaque characteristics compared to normal renal function.
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