Document Detail

Location of acute coronary artery thromboses in patients with and without chronic kidney disease.
MedLine Citation:
PMID:  18818684     Owner:  NLM     Status:  MEDLINE    
Patients with chronic kidney disease have high rates of myocardial infarction and death following an initial attack. Proximal location of coronary atherosclerotic lesions has been linked to the risk of acute myocardial infarction and to infarction-associated mortality. To examine if the spatial distribution of lesions differs in patients with and without chronic kidney disease, we used quantitative coronary angiography to measure this in patients with acute coronary thromboses who were having angiography following acute myocardial infarction. Multivariable linear regression was used to adjust for differences in baseline characteristics. Among 82 patients with stage 3 or higher chronic kidney disease, 55.6% of lesions were located within 30 mm and 87.7% were within 50 mm of the coronary ostia. This compared to 34.7 and 71.8%, respectively, among 299 patients without significant kidney disease. Chronic kidney disease was independently and significantly associated with a 7.0 mm decrease in the distance from the coronary ostia to the problem lesion. Our study suggests that a causal link between a more proximal culprit lesion location in patients with chronic kidney disease and their high mortality rates after myocardial infarct is possible and may have important implications for interventions to prevent infarction.
David M Charytan; Richard E Kuntz; Michael Garshick; Susana Candia; M Faisal Khan; Laura Mauri
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-09-24
Journal Detail:
Title:  Kidney international     Volume:  75     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-18     Completed Date:  2009-02-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  80-7     Citation Subset:  IM    
Renal Division and Clinical Biometrics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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MeSH Terms
Aged, 80 and over
Case-Control Studies
Coronary Angiography
Coronary Artery Disease / mortality,  pathology*
Coronary Thrombosis / diagnosis*,  mortality,  pathology
Glomerular Filtration Rate
Kidney Diseases / complications*
Middle Aged
Myocardial Infarction / etiology,  mortality
Comment In:
Kidney Int. 2009 Jan;75(1):7-9   [PMID:  19092811 ]

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