An optical coherence tomography comparison of coronary arterial plaque calcification in patients with end-stage renal disease and diabetes mellitus

Joseph R Weber; Brendan Martin; Nicholas Kassis; Kunal Shah; Tomas Kovarnik; Holly Mattix-Kramer; John J Lopez

doi:10.1177/1479164120958425

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An optical coherence tomography comparison of coronary arterial plaque calcification in patients with end-stage renal disease and diabetes mellitus

Journal article

Open access

Peer reviewed

An optical coherence tomography comparison of coronary arterial plaque calcification in patients with end-stage renal disease and diabetes mellitus

Joseph R Weber, Brendan Martin, Nicholas Kassis, Kunal Shah, Tomas Kovarnik, Holly Mattix-Kramer and John J Lopez

Diabetes & vascular disease research, Vol.17(5), pp.1479164120958425-1479164120958425

09/01/2020

DOI: 10.1177/1479164120958425

PMCID: PMC7919205

PMID: 32981349

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Abstract

Coronary arterial plaques in patients with end-stage renal disease (ESRD) are assumed to have increased calcification due to underlying renal disease or initiation of dialysis. This relationship may be confounded by comorbid type 2 diabetes mellitus (DM). From a single-center OCT registry, 60 patients were analyzed. Twenty patients with ESRD and diabetes (ESRD-DM) were compared to 2 groups of non-ESRD patients: 20 with and 20 without diabetes. In each patient, one 20 mm segment within the culprit vessel was analyzed. ESRD-DM patients exhibited similar calcium burden, arc, and area compared to patients with diabetes alone. When compared to patients without diabetes, patients with diabetes exhibited a greater summed area of calcium (DM: Median 9.0, IQR [5.3-28] mm vs Non-DM: 3.5 [0.1-14] mm , = 0.04) and larger calcium deposits by arc (DM: Mean 45 ± SE 6.2° vs Non-DM: 21 ± 6.2°, = 0.01) and area (DM: 0.58 ± 0.10 mm vs Non-DM: 0.26 ± 0.10 mm , = 0.03). Calcification deposits in ESRD-DM patients (0.14 ± 0.02 mm) and patients with diabetes (0.14 ± 0.02 mm) were more superficially located relative to patients without diabetes (0.21 ± 0.02 mm), = 0.01 for both. Coronary calcification in DM and ESRD-DM groups exhibited similar burden, deposit size, and depth within the arterial wall. The increase in coronary calcification and cardiovascular disease events seen in ESRD-DM patients may not be secondary to ESRD and dialysis, but instead due to a combination of declining renal function and diabetes.

Aged

Coronary Artery Disease - diagnostic imaging

Coronary Artery Disease - etiology

Diabetes Mellitus, Type 2 - complications

Diabetes Mellitus, Type 2 - diagnosis

Female

Heart Disease Risk Factors

Humans

Kidney Failure, Chronic - complications

Kidney Failure, Chronic - diagnosis

Kidney Failure, Chronic - therapy

Male

Middle Aged

Plaque, Atherosclerotic

Predictive Value of Tests

Registries

Renal Dialysis

Retrospective Studies

Tomography, Optical Coherence

Vascular Calcification - diagnostic imaging

Vascular Calcification - etiology

Details

Title: Subtitle: An optical coherence tomography comparison of coronary arterial plaque calcification in patients with end-stage renal disease and diabetes mellitus
Creators: Joseph R Weber - Loyola University Medical Center
Brendan Martin - Loyola University Medical Center
Nicholas Kassis - Loyola University Chicago
Kunal Shah - Loyola University Medical Center
Tomas Kovarnik - Charles University
Holly Mattix-Kramer - Loyola University Medical Center
John J Lopez - Loyola University Medical Center
Resource Type: Journal article
Publication Details: Diabetes & vascular disease research, Vol.17(5), pp.1479164120958425-1479164120958425
DOI: 10.1177/1479164120958425
PMID: 32981349
PMCID: PMC7919205
NLM abbreviation: Diab Vasc Dis Res
ISSN: 1479-1641
eISSN: 1752-8984
Grant note: T35 HL120835 / NHLBI NIH HHS
Language: English
Date published: 09/01/2020
Academic Unit: Electrical and Computer Engineering
Record Identifier: 9984627312402771

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