Photo Credit: Ekaterina Chizhevskaya

The following is a summary of “Carotid plaque thickness predicts cardiovascular events and death in patients with chronic kidney disease,” published in the October 2024 issue of Nephrology by Bjergfelt et al. 

Classical risk scores underestimate cardiovascular risk in chronic kidney disease (CKD). Coronary artery calcium score (CACS) and maximal carotid plaque thickness (cPTmax) predict cardiovascular events in CKD. 

Researchers conducted a retrospective study to analyze whether cPTmax can predict cardiovascular events in CKD and compare its predictive value with CACS. 

They assessed 200 patients with CKD stage 3 from the Copenhagen CKD Cohort using ultrasound to measure cPTmax. Participants were grouped by cPTmax: no plaques, cPTmax 1.0–1.9 mm, and cPTmax >1.9 mm (median cPTmax = 1.9 mm among patients with plaques). A non-contrast CT scan was performed on 175 patients to measure CACS. The follow-up period extended from the ultrasound scan to a predefined end date or the time of the first event, defined as a composite of major cardiovascular events or death of any cause (MACE).  

The results showed that during a median follow-up of 5.4 years, 45 patients (22.5%) developed MACE. In a Cox regression adjusted for classical cardiovascular risk factors, patients with cPTmax >1.9 mm had a significantly higher hazard ratio for MACE (HR 3.2, CI: 1.1–9.3, P = 0.031) compared to those without plaques. C-statistics revealed similar improvements in models predicting MACE with cPTmax (0.247, CI: 0.181–0.312) and CACS (0.243, CI: 0.172–0.315), compared to a model controlled for time since baseline (a Cox model with no covariates). 

The study concluded that cPTmax may be useful for predicting MACE in CKD. They found that cPTmax and CACS had similar predictive abilities for MACE. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03831-4