通过确定冠状动脉斑块负担来对患心血管疾病的冠状动脉度为零,最小和轻度的风险分层
Salman Ansari1, Leili Pourafkari2, April Kinninger2
1California University of Science and Medicine - School of Medicine, Colton, CA, USA.
Journal of cardiovascular computed tomography
|December 14, 2023
概括
即使是最小的冠状动脉 (CAC) 评分为1-10,也表明比零的CAC评分更大的斑块负担和更高的冠状动脉疾病 (CVD) 风险. 这一发现支持使用CAC类别0,1-10和11-100来改进心血管疾病风险评估.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 预防医学 预防医学
背景情况:
- 冠状动脉 (CAC) 评分正在扩大用于心血管疾病 (CVD) 风险评估.
- 现有的CAC风险类别有所不同,这促使评估特定的得分范围.
- 这项研究重点关注CAC分数为0,1-10和11-100的患者的斑块负担.
研究的目的:
- 为了评估不同CAC得分类别的冠状动脉斑块负担 (0,1-10,11-100).
- 确定CAC评分的最佳使用,以完善心血管疾病风险分层.
- 为了比较与CAC得分相关的斑块组成和体积.
主要方法:
- 分析了前性CCTA试验数据,其CAC得分≤100.
- 进行了定量冠状动脉斑块分析.
- CAC被分为零 (0),最小 (1-10) 和轻度 (11-100) 的组.
- 使用多变量回归评估了斑块特征 (例如,非化,化),并根据心血管风险因素进行了调整.
主要成果:
- 分析了378名受试者 (53%为女性,平均年龄为53.9岁).
- 51%的CAC为零,16%的CAC为最小,33%的CAC为轻度.
- 最小CAC (1-10) 和轻度CAC (11-100) 组显示传统心血管疾病风险因素的患病率更高.
- 与零CAC相比,最小的CAC与显著更高的纤维状斑块,总非化斑块和总斑块体积有关.
- 与最小CAC相比,轻度CAC显示所有斑块类型的体积显著更高.
结论:
- 具有最小CAC (1-10) 的个体比零CAC的个体表现出更大的非化和总冠状动脉斑块体积.
- 在最小的CAC组中增加的斑块负担意味着心血管疾病风险更高.
- 使用CAC类别的0,1-10,和11-100提供了更精确的冠状动脉血管疾病风险分层.
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