多基因风险与长期冠状动脉斑块进展和高风险斑块相关
Nick S Nurmohamed1, Injeong Shim2, Emilie L Gaillard3
1Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA.
JACC. Cardiovascular imaging
|August 17, 2024
概括
高冠状动脉疾病多原风险评分 (PRS) 与长期增加的斑块积累和高风险的斑块特征有关. 这一发现突显了PRS作为未来心血管事件的重要预测因素.
科学领域:
- 心血管疾病的研究研究.
- 遗传学和个性化医学
- 医学成像分析分析 医学成像分析
背景情况:
- 冠状动脉疾病 (CAD) 多基因风险评分 (PRS) 和长期斑块进展之间的关系,包括高风险斑块 (HRP) 特征,仍然在很大程度上没有特征.
- 了解这种关联对于完善风险分层和指导患有CAD风险的个体的预防策略至关重要.
研究的目的:
- 调查CAD PRS对冠状动脉斑块长期进展的影响.
- 评估CAD PRS与高风险斑块 (HRP) 特性发展之间的关联.
主要方法:
- 这是一项前性研究,涉及接受CAD PRS测量和连续冠状动脉计算机断层扫描 (CTA) 图像成像的患者,平均时间为10.2年.
- 利用基于人工智能的算法对冠状动脉CTA扫描进行定量分析,以评估斑块体积和特征.
- 采用线性混合效应模型来分析CAD PRS,肌动脉瘤体积 (PAV) 百分比进展,非化斑块进展和HRP患病率之间的关系,调整为传统风险因素.
主要成果:
- 患有高CADPRS的患者表现出显著更高的基线PAV (10.4%对1.9%) 和与PAV进展的更大关联 (每10年增加0.69%每1个SD增加CADPRS).
- 与单独使用常规风险因素相比,CAD PRS在区分高于中位数的非化斑块进展方面表现出了附加值 (AUC 0.73 与 0.69).
- 高CAD PRS与HRP在基线 (OR 2.85) 和随访 (OR 6.16) 的存在密切相关.
结论:
- 多基因风险显著影响长期冠状动脉斑块的进展和高风险斑块特征的发展,在怀疑患有CAD的患者.
- CAD PRS作为未来心血管斑块负担和不良斑块形态学的有价值的独立预测器.
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