使用冠状动脉评分作为诊断工具在症状慢性冠状动脉综合征患者在现实生活中的设置
M Patrick Witvliet1,2, E Karin Arkenbout3, Pieter W Kamphuisen1,4
1Department of Internal Medicine, Tergooi Medical Center, Hilversum, the Netherlands.
Vascular health and risk management
|September 11, 2023
概括
冠状动脉 (CAC) 评分有效地改进了冠状动脉疾病 (CAD) 的可能性,当与前测试概率结合时. CAC得分与冠状动脉血管造影结果的关联比运动心电图更强,这表明它在诊断胸痛方面的有用性.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 医学诊断 医学诊断 医学诊断
背景情况:
- 冠状动脉 (CAC) 评分是评估冠状动脉疾病 (CAD) 的可能性的一种方法.
- 前测试概率 (PTP) 将患者分为低风险,中等风险和高风险.
- 运动心电图 (ECG) 是评估胸痛的常见诊断工具.
研究的目的:
- 为了比较CAC得分的诊断实用性与CAD的测试前概率 (PTP).
- 为了比较CAC得分与运动心电图在诊断CAD.
- 为了评估CAC得分和运动心电图对冠状动脉血管学.
主要方法:
- 对882名患有心痛和/或呼吸障碍的患者进行了回顾性分析.
- 将CAC分数与PTP,运动心电图结果和冠状动脉血管学结果进行比较.
- 使用克莱默的V来评估变量之间的关联的统计分析.
主要成果:
- 较高的PTP与较高的CAC得分有显著的相关性 (克莱默的V = 0.29,p < 0.0001).
- CAC评分显示与冠状动脉血管造影严重程度有显著的关联 (克莱默的V=0.43,p<0.0001).
- 运动心电图显示与冠状动脉血管造影没有显著的关联 (克莱默的V = 0.11,p = 0.91).
结论:
- CAC得分可以提高或降低超越PTP的CAD的可能性.
- 在诊断胸痛时,CAC得分可能比运动心电图更有价值.
- CAC评分与解剖学疾病严重程度的相关性比运动心电图更强.
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