预防ASCVD事件:使用冠状动脉化得分来个性化风险和指导类药物治疗
Joel Kupfer1, Helme Silvet2, Samuel M Aguayo1
1Carl T. Hayden Veterans Affairs Medical Center, Phoenix, Arizona.
概括
使用低剂量CT扫描的肺癌查 (LCS) 可以识别冠状动脉化 (CAC) 风险. 这有助于预防高风险吸烟者的动脉样硬化心血管疾病 (ASCVD) 事件.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 放射学 放射学是指放射学
背景情况:
- 肺癌是癌症死亡的主要原因之一,吸烟是主要的危险因素.
- 肺癌风险较高的吸烟者也面临着动脉样硬化心血管疾病 (ASCVD) 发病率和死亡率的重大风险.
- 肺癌查 (LCS) 为ASCVD事件预防提供了一个机会.
研究的目的:
- 审查使用冠状动脉化 (CAC) 评分用于初级预防的临床差异,以及在接受LCS的吸烟者中接受他类药物治疗的指导.
- 为在LCS环境中将CAC分数纳入ASCVD风险管理提供建议.
主要方法:
- 对LCS中低剂量计算机断层扫描 (LDCT) 的CAC评分现有文献的审查.
- 对吸烟者与普通人群的CAC分数解释差异的分析.
- 在LCS期间对ASCVD预防策略的综合建议.
主要成果:
- 用于LCS的LDCT扫描可以揭示CAC的程度,这是一个独立的ASCVD风险因素.
- 与一般人群相比,CAC评分的解释及其在指导初级预防和他类药物治疗中的应用对于符合LCS条件的吸烟者不同.
- 将CAC发现集成到LCS协议中可以增强ASCVD风险分层.
结论:
- 在LCS期间从LDCT获得的CAC得分可以为ASCVD事件预防策略提供信息.
- 建议提供了利用CAC得分,结合心脏检测,并确定需要心血管专家转诊的LCS患者.
- 在LCS计划中优化ASCVD风险管理对于高风险吸烟者至关重要.
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