Key result
Lower eGFR is linked to ~36% higher odds of coronary lipid-rich plaque per SD.
Why the study?
The cardiovascular-kidney-metabolic framework links metabolic and renal dysfunction to cardiovascular risk, but whether these disturbances are reflected in coronary plaque composition and intraplaque lipid burden remains incompletely understood.
Are metabolic and renal dysfunction (lower eGFR and higher HbA1c) associated with greater intraplaque lipid burden and lipid-rich plaque in patients undergoing percutaneous coronary intervention with pre-intervention NIRS-IVUS imaging?
Cross-Sectional (n=483)
Are metabolic and renal dysfunction (lower eGFR and higher HbA1c) associated with greater intraplaque lipid burden and lipid-rich plaque in patients undergoing percutaneous coronary intervention with pre-intervention NIRS-IVUS imaging?
Answers are grounded in this paper and cite their sources.
Metabolic and renal dysfunction (higher HbA1c and lower eGFR) are independently associated with greater coronary intraplaque lipid burden on NIRS-IVUS, providing intracoronary imaging evidence supporting the cardiovascular–kidney–metabolic axis.
Background The cardiovascular–kidney–metabolic framework emphasizes the interrelated contributions of metabolic and renal dysfunction to cardiovascular risk. Whether these disturbances are reflected in coronary plaque composition remains incompletely understood. We evaluated the association of metabolic and renal dysfunction with intraplaque lipid burden using near‐infrared spectroscopy intravascular ultrasound. Methods Intraplaque lipid burden was assessed by the maximum lipid core burden index (LCBI) within a 4‐mm segment ( max LCBI 4mm ), and lipid‐rich plaque (LRP) was defined as max LCBI 4mm ≥324.7. Multivariable linear regression models were constructed with max LCBI 4mm as the dependent variable, and multivariable logistic regression models were used to evaluate associations with LRP. Results Among 483 patients undergoing percutaneous coronary intervention with pre‐intervention near‐infrared spectroscopy intravascular ultrasound imaging, lower estimated glomerular filtration rate and higher hemoglobin A1c were independently associated with greater intraplaque lipid burden and higher odds of LRP. In analyses standardized per 1 SD, low‐density lipoprotein cholesterol showed the strongest association with max LCBI 4mm (β=52.51; 95% CI, 27.49–77.53), followed by estimated glomerular filtration rate (β=33.38; 95% CI, 9.97–56.80) and hemoglobin A1c (β=24.71; 95% CI, 3.71–45.71). Similarly, lower estimated glomerular filtration rate (odds tatio [OR], 1.36; 95% CI, 1.06–1.75) and higher hemoglobin A1c (OR, 1.37; 95% CI, 1.05–1.77) were independently associated with LRP. No significant interaction between estimated glomerular filtration rate and hemoglobin A1c was observed. Conclusions Metabolic and renal dysfunction are independently associated with intraplaque lipid burden assessed by near‐infrared spectroscopy intravascular ultrasound. These findings provide intracoronary imaging evidence linking the cardiovascular–kidney–metabolic framework to plaque‐level lipid accumulation.
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Kook et al. (2026) conducted a cross-sectional in Coronary artery disease undergoing percutaneous coronary intervention (n=483). Metabolic and renal dysfunction (lower eGFR, higher HbA1c, and LDL cholesterol) was evaluated on Lipid-rich plaque (defined as maximum lipid core burden index within a 4-mm segment [max LCBI 4mm] ≥324.7) and continuous max LCBI 4mm (OR 1.36 (for lower eGFR per 1 SD); OR 1.37 (for higher HbA1c per 1 SD), 95% CI 1.06-1.75). Lower eGFR and higher HbA1c were independently associated with higher odds of coronary lipid-rich plaque.
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