胸腔与冠状动脉化对动脉样硬化心血管疾病事件预测事件的预测
Keishi Ichikawa1, Rui Wang2, Robyn L McClelland2
1The Lundquist Institute, Torrance, California, USA keishi.ichikawa@lundquist.org.
Heart (British Cardiac Society)
|April 16, 2024
概括
胸部CT上的胸动脉 (TAC) 和心脏CT上的冠状动脉 (CAC) 都预测了动脉样硬化心血管疾病 (ASCVD) 事件. 然而,CAC得分为ASCVD风险预测提供了更好的预后价值.
科学领域:
- 心血管成像 - 心血管成像
- 放射学 放射学是一门学科.
- 预防性心脏病学 预防性心脏病学
背景情况:
- 胸部CT图中的胸动脉 (TAC) 和心电图中心脏CT图中的冠状动脉 (CAC) 是心血管风险的标志物.
- 在动脉样硬化心血管疾病 (ASCVD) 事件中,TAC的预后值,包括大动脉,与CAC相比,需要进一步调查.
研究的目的:
- 为了比较胸部CT上的量化胸动脉 (TAC) 的预后值,与心电图启动的心脏CT上的冠状动脉 (CAC) 评分,以预测发生的ASCVD事件.
主要方法:
- 利用了多民族动脉样硬化检查研究5的2412名参与者的数据,这些参与者接受了胸部CT和心电图心脏CT.
- 在胸部CT上使用Agatston方法测量TAC,在心脏CT上测量CAC得分.
- 使用依赖时间的接收器运行特征 (ROC) 曲线和多变量考克斯回归分析在8.8年的中位数随访期间比较预后值.
主要成果:
- 在TAC和CAC得分之间观察到显著的相关性 (0.46,p<0.001).
- 无论是TAC (HR 1.31) 和CAC (HR 1.82) 都与ASCVD事件独立相关.
- 与TAC相比,CAC得分显示,与TAC相比,时间依赖的ROC曲线下面面积显著增加 (0.698比0.641,p=0.031),特别是在中等至高ASCVD风险的个体中.
结论:
- 虽然胸部CT上的TAC显示出与ASCVD事件的显著关联,并提供了补充风险数据,但它不能取代ECG启动的心脏CT上的CAC评分.
- 与TAC相比,CAC得分在预测ASCVD事件方面具有更高的预后价值.
- 这些发现突出了TAC和CAC在心血管风险评估中的不同但互补的作用.
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