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Relationship between left main and left anterior descending arteries bifurcation angle and coronary artery calcium score in chronic kidney disease : A 3-dimensional analysis of coronary computed tomography

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Title: Relationship between left main and left anterior descending arteries bifurcation angle and coronary artery calcium score in chronic kidney disease : A 3-dimensional analysis of coronary computed tomography
Authors: Konishi, Takao Browse this author
Funayama, Naohiro Browse this author
Yamamoto, Tadashi Browse this author
Hotta, Daisuke Browse this author
Tanaka, Shinya Browse this author →KAKEN DB
Issue Date: 12-Jun-2018
Publisher: The Public Library of Science
Journal Title: PLoS ONE
Volume: 13
Issue: 6
Start Page: e0198566
Publisher DOI: 10.1371/journal.pone.0198566
Abstract: Background: A high coronary artery calcium score (CACS) predicts a poor prognosis in patients with coronary artery disease. We examined the relationship between the bifurcation angle and the CACS of the left main (LM) and left anterior descending (LAD) arteries in patients suffering from chronic kidney disease (CKD). Methods: We analyzed the data of 121 patients who underwent coronary computed tomography between October 2014 and June 2015 and whose estimated glomerular filtration rate (eGFR) was <60 ml/min/1.73 m2. The LM-LAD bifurcation angle was measured by 3-dimensional coronary computed tomography. The CACS of the LM-LAD arteries was also calculated. We excluded stent recipients and patient who had undergone coronary artery bypass graft surgery. Results: In the overall sample, the mean ± standard deviation (range) LM-LAD bifurcation angle was 35.9 ± 11.4° (6.8-79.4°) and mean CACS was 227 ± 351 (0 to 1,695). The mean LM-LAD arteries angle was 40.3° ± 10.0° in 39 patients whose CACS was ≥200, versus 33.8° ± 11.6° in 82 patients with CACS <200 (p = 0.003). A weak, but positive correlation (r = 0.269, p = 0.003) was observed between the LM-LAD arteries angle and CACS of the LM-LAD arteries. By multiple variable analysis, hemoglobin A1c, triglycerides, eGFR and the LM-LAD arteries angle were independent predictors of a high CACS of the LM-LAD arteries. Conclusion: In patients with CKD, a wide LM-LAD arteries angle was associated with a high CACS of the LM-LAD arteries. The prognostic value of this observation warrants further evaluation.
Rights: http://creativecommons.org/licenses/by/4.0/
Type: article
URI: http://hdl.handle.net/2115/71240
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 小西 崇夫

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