Increased renal cortical stiffness is associated with coronary artery disease severity in patients with acute coronary syndrome

Abstract

Atherosclerosis is the primary etiological factor associated with acute coronary syndrome (ACS). Kidneys have a highly arterial vascular structure and are therefore commonly affected by atherosclerosis, including those affecting the coronary arteries. Renal shear wave elastography (SWE) is an ultrasonographic method, which provides reliable information regarding the condition of the renal parenchyma. We investigated the relationship between SWE findings and the severity of coronary atherosclerosis. We calculated the following: the renal cortical stiffness (rCS) evaluated via SWE, the renal resistive index, the renal pulsatility index, the acceleration time, and the mean Syntax score (SS). Patients with a mean SS <12 were categorized into a low-risk (LR) and those with a mean SS ≥12 were categorized into the high-risk (HR) group. Our study included 132 patients—76 in the LR and 56 in the HR group. Creatinine, high-sensitivity C-reactive protein (hs-CRP), and rCS were significantly higher, but the glomerular filtration rate (GFR) was significantly lower in the HR group. The Hs-CRP (odds ratio [OR] 1.220), GFR (OR 0.967), and rCS (OR 1.316) were observed to be independent predictors for the HR group. The cutoff value of rCS using receiver-operating characteristic curve analysis was 4.43 for the prediction of HR patients and showed 60.7% sensitivity and 57.9% specificity (area under the curve 0.642). SWE which shows renal parenchymal injury and atherosclerosis in renal vessels may give an idea about the severity of coronary atherosclerosis.

The Relationship between Renal Resistive Index and Complexity of Coronary Lesions in Patients with Stable Coronary Artery Diseases

“…However, our results came in contrast with Demirtaş and Bulut who reported that RRI in the low-risk ACS patients (mean SYNTAX Score 12) was 0.73 0.07 while in high risk patients (mean SYNTAX Score 12) was 0.76 0.08 without significant differences between both groups. Higher RRI observed in this high risk group may be related to acute stress, however, non-significant difference could be attributed to difficult Doppler assessment of the kidneys due to retroperitoneal location, difficult assessment in obese patients and limited efficacy of shear wave elastography (SWE) using the acoustic radiation force impulse imaging modality in the kidneys located deeper than 5 cm [ 37 ]. Of note, these results could be considered as novel ones as the study exclusively included stable CAD patients; not ACS patients, without renal impairment (eGFR 50 mL/min/1.73 ).…”