Chronic kidney disease is associated with neovascularization and intraplaque hemorrhage in coronary atherosclerosis in elders: Results from the Hisayama Study

Toshiaki Nakano, Toshiharu Ninomiya, Shinji Sumiyoshi, Mitsuho Onimaru, Hiroshi Fujii, Hiroyuki Itabe, Yutaka Nakashima, Katsuo Sueishi, Kazuhiko Tsuruya, Yoshinao Oda, Takanari Kitazono, Yutaka Kiyohara

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Abstract

There is little information regarding whether patients with chronic kidney disease (CKD) have a high incidence of vulnerable plaques in their coronary arteries. To gain additional evidence on this, we conducted a population-based study by randomly selecting 126 subjects from 844 consecutive autopsies of elderly residents of Hisayama, Japan. We then determined the relationships of CKD with neovascularization and intraplaque hemorrhage in coronary atherosclerosis with the subjects classified into four categories based on their estimated glomerular filtration rate (eGFR). Areas of oxidized low-density lipoprotein (oxLDL) and vascular endothelial growth factor (VEGF) expression, assessed by immunohistochemistry in a total of 375 coronary arteries, increased significantly with decreasing eGFR. A lower eGFR was also associated with increased numbers of newly formed blood vessels. These relationships remained substantially unchanged after adjustment for confounding factors. The multivariate-adjusted odds ratio of the presence of intraplaque hemorrhages was 6.2 (95% confidence interval, 1.1-35.0) in patients with an eGFR <30 ml/min/1.73 m2 compared with those with an eGFR of ≥60 ml/min/1.73 m2. Thus, elderly patients with CKD have intimal neoangiogenesis and an increased risk of intraplaque hemorrhage in coronary arteries, possibly favored by local accumulation of oxLDL and VEGF.

Original languageEnglish
Pages (from-to)373-380
Number of pages8
JournalKidney International
Volume84
Issue number2
DOIs
Publication statusPublished - Jan 1 2013

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Glomerular Filtration Rate
Chronic Renal Insufficiency
Coronary Artery Disease
Hemorrhage
Coronary Vessels
Vascular Endothelial Growth Factor A
Tunica Intima
Blood Vessels
Autopsy
Japan
Immunohistochemistry
Odds Ratio
Confidence Intervals
Incidence
Population
oxidized low density lipoprotein

All Science Journal Classification (ASJC) codes

  • Nephrology

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Chronic kidney disease is associated with neovascularization and intraplaque hemorrhage in coronary atherosclerosis in elders : Results from the Hisayama Study. / Nakano, Toshiaki; Ninomiya, Toshiharu; Sumiyoshi, Shinji; Onimaru, Mitsuho; Fujii, Hiroshi; Itabe, Hiroyuki; Nakashima, Yutaka; Sueishi, Katsuo; Tsuruya, Kazuhiko; Oda, Yoshinao; Kitazono, Takanari; Kiyohara, Yutaka.

In: Kidney International, Vol. 84, No. 2, 01.01.2013, p. 373-380.

Research output: Contribution to journalArticle

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