BACKGROUND: 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). METHODS: 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. RESULTS: 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] mm2 vs Non-DM: 3.5 [0.1-14] mm2, p = 0.04) and larger calcium deposits by arc (DM: Mean 45 ± SE 6.2° vs Non-DM: 21 ± 6.2°, p = 0.01) and area (DM: 0.58 ± 0.10 mm2 vs Non-DM: 0.26 ± 0.10 mm2, p = 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), p = 0.01 for both. CONCLUSIONS: 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.
- MeSH
- aterosklerotický plát * MeSH
- chronické selhání ledvin komplikace diagnóza terapie MeSH
- diabetes mellitus 2. typu komplikace diagnóza MeSH
- dialýza ledvin MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci koronárních tepen diagnostické zobrazování etiologie MeSH
- optická koherentní tomografie * MeSH
- prediktivní hodnota testů MeSH
- registrace MeSH
- retrospektivní studie MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- senioři MeSH
- vaskulární kalcifikace diagnostické zobrazování etiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- srovnávací studie MeSH
The prevalence of the metabolic syndrome among developed countries is rising, and this is largely driven by increasing obesity rates. Central obesity plays a key role in the pathogenesis of the metabolic syndrome: it promotes inflammation, hypertension and dyslipidaemia, and leads to the development of type 2 diabetes mellitus and atherosclerosis. Clinical management should be focused on multifactorial intervention to address all the associated cardiovascular risk factors. The atherogenic mixed dyslipidaemic profile associated with the metabolic syndrome is an important target for intervention to reduce the risk of type 2 diabetes and premature cardiovascular disease.
- MeSH
- ateroskleróza epidemiologie etiologie komplikace prevence a kontrola MeSH
- diabetes mellitus 2. typu epidemiologie etiologie komplikace prevence a kontrola MeSH
- dyslipidemie epidemiologie komplikace terapie MeSH
- financování organizované MeSH
- hodnocení rizik MeSH
- hypertenze epidemiologie komplikace terapie MeSH
- kardiovaskulární nemoci epidemiologie etiologie prevence a kontrola MeSH
- lidé MeSH
- metabolický syndrom epidemiologie komplikace terapie MeSH
- obezita epidemiologie komplikace terapie MeSH
- prevalence MeSH
- rizikové faktory MeSH
- věkové rozložení MeSH
- Check Tag
- lidé MeSH
