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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
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Valor pronóstico a largo plazo de la calcificación coronaria detectada por tomografía computarizada de haz de
P C Keelan1, L F Bielak, K Ashai
1Division of Cardiovascular Diseases, Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Circulation
|July 27, 2001
Resumen
La extensión de la calcificación de la arteria coronaria (CAC) de la TC de haz de electrones (EBCT) predice futuros eventos cardíacos como la muerte o el infarto de miocardio (IM). Las puntuaciones más altas de CAC indican un mayor riesgo, y la edad también es un predictor significativo.
Área de la Ciencia:
- Cardiología Cardiología.
- Radiología Radiología.
- La medicina preventiva es la medicina preventiva de las enfermedades.
Sus antecedentes:
- La TC con haz de electrones (TCE) permite la evaluación no invasiva de la aterosclerosis coronaria a través de la cuantificación de la calcificación de la arteria coronaria (CAC).
- Estudios previos han explorado el CAC como un predictor de eventos cardíacos, pero la validación adicional en diversas cohortes de pacientes está en curso.
Objetivo del estudio:
- Evaluar si la extensión de la CAC, medida por EBCT durante la angiografía coronaria, predice futuros eventos cardíacos adversos importantes (MACE).
- Para comparar el poder predictivo de la extensión del CAC con los factores de riesgo tradicionales de la enfermedad de las arterias coronarias (CAD), la historia previa de CAD y los hallazgos angiográficos.
Principales métodos:
- Un estudio de seguimiento que involucró a 288 pacientes que se sometieron tanto a angiografía coronaria como a EBCT.
- Los pacientes fueron monitoreados durante una media de 6,9 años para eventos cardíacos duros (muerte cardíaca, infarto de miocardio no fatal).
- Se emplearon modelos de riesgos proporcionales de Cox para analizar las capacidades predictivas de varios factores, incluida la puntuación CAC.
Principales resultados:
- La edad avanzada y una mayor extensión de CAC fueron predictores significativos de eventos cardíacos duros.
- Los pacientes con una puntuación CAC <20 tuvieron una tasa de eventos muy baja (1 de 87).
- La supervivencia libre de eventos fue significativamente mejor para los pacientes con puntuaciones CAC <100 en comparación con aquellos con puntuaciones ≥100.
Conclusiones:
- La extensión de CAC determinada por EBCT es un fuerte predictor de futuros eventos cardíacos duros en pacientes sometidos a angiografía coronaria.
- La cuantificación del CAC proporciona información pronóstica valiosa más allá de los factores de riesgo tradicionales y los datos angiográficos.
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