Prediction of coronary artery disease by transesophageal echocardiographic detection of thoracic aortic plaque in patients with chronic kidney disease

被引:1
作者
Leskinen, Yrjo
Groundstroem, Kaj
Virtanen, Vesa
Lehtimaki, Terho
Huhtala, Heini
Saha, Heikki
机构
[1] Tampere Univ Hosp, Dept Internal Med, FI-33521 Tampere, Finland
[2] Tampere Univ Hosp, Ctr Heart, Tampere, Finland
[3] Tampere Univ Hosp, Lab Atherosclerosis Genet, Dept Clin Chem, Ctr Lab Med, Tampere, Finland
[4] Tampere Univ Hosp, Res Unit, Tampere, Finland
[5] Univ Tampere, Sch Publ Hlth, FIN-33101 Tampere, Finland
[6] Univ Tampere, Sch Med, FIN-33101 Tampere, Finland
来源
NEPHRON CLINICAL PRACTICE | 2006年 / 103卷 / 04期
关键词
aortic plaque; chronic kidney disease; coronary artery disease; transesophageal echocardiography;
D O I
10.1159/000092913
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background/Aims: Our aim was to examine the significance of thoracic aortic plaque detected by transesophageal echocardiography (TEE) in the prediction of coronary artery disease (CAD) in patients with chronic kidney disease (CKD). Methods: We examined 118 patients (mean age 52 +/- 12 years) with CKD and followed them for a mean of 3.4 +/- 0.8 years. The study group included 52 predialysis patients with moderate to severe CKD (plasma creatinine >= 200 mu mol/l), 32 patients on dialysis treatment, and 34 renal transplant recipients. At baseline, TEE was performed to evaluate thoracic aortic atherosclerosis. CAD was defined by a history of a documented myocardial infarction, a coronary angiogram or a post-mortem autopsy finding showing significant occlusive CAD by the end of the follow-up period. Results: CAD was documented in 31 (26%) of the 118 study patients. The presence of thoracic aortic plaque had a sensitivity of 100% and a specificity of 37% for CAD and the positive and negative predictive values were 36 and 100%, respectively. In the subset of 36 patients with morphological findings of coronary arteries by angiogram or autopsy, the presence of large thoracic aortic plaques (>= 3 mm in diameter) had a 73% sensitivity and 90% specificity for significant coronary artery stenosis. The positive and negative predictive values were 95 and 56%, respectively. Conclusion: TEE may be used for detecting high-risk patients with CKD; the absence of thoracic aortic plaque predicted the absence of CAD, and the presence of large aortic plaques predicted significant coronary artery stenosis. Copyright (c) 2006 S. Karger AG, Basel.
引用
收藏
页码:C157 / C161
页数:5
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