Quantitative coronary plaque characteristics on coronary computed tomography angiography and their prognostic value in patients with chronic kidney disease
Year: 2026
Type: article
Abstract: Background: Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular events. This study compared coronary plaque characteristics assessed by coronary computed tomography angiography (CCTA) between patients with and without CKD and evaluated their associations with major adverse cardiovascular events (MACE). Methods: . Propensity score matching (1:3) used age, sex, hypertension, diabetes mellitus, smoking, family history of coronary artery disease, and hyperlipidemia. Quantitative plaque characteristics and perivascular fat attenuation index (FAI) were assessed. MACE comprised all-cause death, non-fatal myocardial infarction, stroke, or revascularization >90 days after CCTA. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs); analyses of CCTA-derived predictors were adjusted for age, body mass index, and hypertension. High plaque burden was defined as total plaque burden in the highest quartile. Results: 4.35%; all P<0.001). Among patients with CKD, lipid plaque burden (adjusted HR =1.107, 95% CI: 1.006-1.218; P=0.038) and high FAI (adjusted HR =4.027, 95% CI: 2.329-6.960; P<0.001) were independently associated with MACE. Compared with patients without CKD and with low plaque burden, those with CKD and high plaque burden had a higher risk of MACE (adjusted HR =6.153, 95% CI: 2.937-12.890; P<0.001). Conclusions: CKD was associated with greater coronary plaque burden and a higher incidence of MACE. Lipid plaque burden and high FAI were independently associated with MACE after adjustment for age, body mass index, and hypertension, supporting their potential role in cardiovascular risk assessment in patients with CKD.
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223236253