在多样化的患者群体中,高风险CCTA表型的心脏代谢预测因素
Toshiki Kuno1, Javier Arce1, Michael Fattouh1
1Cardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United States.
American journal of preventive cardiology
|September 7, 2023
概括
低衰减非化斑块 (LAP) 负担预测心血管结果,特别是在西班牙裔患者中. 与高血压等风险因素相关的LAP升高是显著的预后标志物.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 生物标志物 生物标志物
背景情况:
- 冠状动脉CT血管图 (CCTA) 识别高风险斑块特征,如低衰减非化斑块 (LAP) 和冠状动脉脂肪组织 (PCAT) 炎症.
- 这些成像生物标志物与心血管结果有关.
研究的目的:
- 调查心脏代谢风险因素之间的关系,包括脂蛋白和心表脂肪组织 (EAT),以及CCTA衍生的LAP和血管炎症.
- 评估这些成像生物标志物的预后意义.
主要方法:
- 对364名接受CCTA治疗的患者进行了回顾性分析,以治疗稳定的胸痛.
- 半自动软件用于从CT测量斑块,PCAT和EAT.
- 已定义的LAP升高 (≥4%) 和PCAT减弱 (≥70.5 HU).
- 主要终点:心肌梗塞,再血管化或心血管死亡的组合.
主要成果:
- 升高LAP的患病率为31%,升高PCAT减弱率为18%.
- 在西班牙裔患者中,脂蛋白与LAP负担相关.
- 升高的LAP与老年,糖尿病,高血压,高脂血症,吸烟,高CAC和增加EAT体积有关.
- 升高的LAP,但没有升高的PCAT,与不良心血管结果有显著的关联 (P<0.001).
结论:
- 升高的LAP负担是心血管事件的重要预测因素.
- 诸如高血压和高脂血症等心脏代谢风险因素增加了LAP升高的几率.
- 脂蛋白 (a) 与特定族群 (西班牙裔患者) 的LAP负担存在相关性.
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