冠動脈内皮機能不全は,脳血管疾患のリスクの増加と関連しています

Paul V Targonski¹, Piero O Bonetti, Geralyn M Pumper

¹Division of Community Internal Medicine, Mayo Clinic and Foundation, Rochester, Minn 55905, USA.

Circulation

|May 29, 2003

まとめ

冠動脈内皮機能不全 (CED) は,閉塞性冠動脈疾患のない患者の脳血管疾患のリスクを大幅に増加させます. CEDの早期発見は,積極的な予防戦略のための高リスクの個人を特定するのに役立ちます.

科学分野:

心臓病学心臓病学
神経学神経学とは
血管生物学血管生物学

背景:

脳卒中は,障害や死亡の主な原因であり,しばしばアテロトロンボティック疾患と関連しています.
内皮機能不全は,アテロゲネシスと心血管疾患のリスクの重要な要因です.
冠動脈内皮機能不全 (CED) と脳血管疾患との関連は十分に確立されていません.

研究の目的:

閉塞性冠動脈疾患 (CAD) のない患者におけるCEDと脳血管イベントの関連性を調査する.

主な方法:

阻害性CADのない503人の患者は,冠動脈内皮機能検査を冠動脈内皮アセチルコリン注入で受けました.
患者は,CEDの存在または欠如に基づいて分類されました.
医療記録は,有病および有病の脳血管疾患 (脳卒中,一時的な性血症発作) を調べました.

主要な成果:

cerebrovascular eventsは25件発生し,CED患者では22件,CED患者では3件 (P=0.008) が発生した.
CEDは,リスク要因を調整した後に,脳血管イベント (OR,4.32;95%CI,1.26~14.83) の最強の独立した予測因子でした.
CED患者の累積的な脳血管疾患の発生率は著しく高かった (P=0.04).

結論:

冠動脈内皮機能不全は,阻害性CADのない患者の脳血管疾患のリスクの増加と独立して関連しています.
CEDの検出は,早期の動脈硬化症を特定し,患者に強化された予防措置を警告します.

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