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Abstract: PO1841

The Impact of Calcification on Intraplaque Hemorrhage in Coronary Atherosclerosis from Autopsy Samples: The Hisayama Study

Session Information

Category: Hypertension and CVD

  • 1403 Hypertension and CVD: Mechanisms

Authors

  • Nakano, Toshiaki, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Japan
  • Kitamura, Hiromasa, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Japan
  • Oda, Yoshinao, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Japan
  • Kitazono, Takanari, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Japan
  • Ninomiya, Toshiharu, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Japan
Background

Vascular calcification is the specific feature of arterial change and is often seen in coronary arteries among patients with chronic kidney disease (CKD) and older subjects. The information whether vascular calcification is associated with intraplaque hemorrhage is scarce. We aim to examine how much area of calcification is the highest risk on plaque vulnerability.

Methods

We examined 375 coronary arteries obtained from autopsy samples of subjects with CKD stages 0 to 5 in a general Japanese population. Arteries were divided into quintiles based on vascular calcification area. The association of calcification area with the presence of intraplaque hemorrhage in coronary arteries was estimated by using a logistic regression analysis.

Results

Calcification lesions were counted in 149 coronary arteries. All calcification lesions were existed in intima. Subjects in the fourth quartile of calcification area had a significantly higher likelihood of intraplaque hemorrhage than those in the lowest quintile after adjusting for confounders (odd ratio [95% confidence interval], 19.93 [1.48-267.71]), whereas subjects in highest quintile did not (7.86 [0.61-101.70]). The calcification area at highest risk for the presence of intraplaque hemorrhage was 2.02 mm2, and the risk was constant at greater area than this value in the logistic analysis with restricted cubic spline.

Conclusion

The present study suggests that larger vascular calcification is associated significantly with increased risk for intraplaque hemorrhage, subsequently linking to plaque vulnerability. Above a certain amount of calcification area, these increasing trends may no longer be observed.