Kidney Week

Abstract: FR-PO361

Clinical Characteristics of Undiagnosed Coronary Artery Disease (uCAD) in Individuals Initiating Hemodialysis

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Sugawara, Hirohito, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Hirohito Sugawara, MD, PhD

• Yoshida, Kiryu, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Kiryu Yoshida, MD, PhD

• Saito, Yoshinori, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Yoshinori Saito

• Kato, Masanori, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Masanori Kato

• Yamamoto, Masahiro, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Masahiro Yamamoto, MD

• Ito, Hidetoshi, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Hidetoshi Ito

• Shimazu, Suguru, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Suguru Shimazu, MD

• Ochiai, Masahiko, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Masahiko Ochiai, MD, PhD

• Ogata, Hiroaki, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Hiroaki Ogata, MD, PhD

Background

Although CAD is prevalent in individuals with CKD, it is difficult to evaluate coronary lesion by coronary angiography (CAG) and coronary computed tomography (CCT) in advanced CKD not on HD because of high risk of contrast nephropathy. We examine the prevalence of uCAD and its clinical characteristics in individuals initiating HD.

Methods

We conducted a cross-sectional study of individuals newly starting HD between January 2002 and December 2023 at our hospital. CAD was screened by CCT immediately after starting HD, and then CAD was confirmed by CCT/CAG. The individuals with history of CAD were excluded. After exclusions, the remaining 272 participants were enrolled in the present study.

Results

A total of 272 participants (mean age, 69 years; female 30%; diabetes, 57%). Coronary lesions were detected in 128 participants (47%). The distribution of stenotic lesions was LAD 73%, LCX 44%, and RCA 49%, respectively. Coronary artery calcification (total Agatston score) was significantly observed in participants with CAD as compared with those without CAD (1290 ± 1652 vs. 390 ± 655; P<0.001). Dyslipidemia, diabetes, and past cerebrovascular disease were more prevalent in participants with CAD. Antiplatelet agents including aspirin and statins were frequently prescribed in participants with CAD. T wave inversion in the ECG were more frequently found in participants with CAD. No significant differences were observed in echocardiographic parameters between participants with and those without CAD. The multiple regression analysis indicated that the history of smoking and the levels of albumin (the odds ratio (OR): 0.53 (95% confidence interval [95% CI], 0.31 to 0.91)) and HDL-C (OR: 0.97 (95% CI, 0.95 to 0.99)) was independently and significantly associated with the formation of CAD.

Conclusion

uCAD were found in approximately half of individuals newly starting HD. Coronary lesions were frequently found in LAD artery. HDL-C and albumin were associated with uCAD.