在接受隔离性大动脉门手术的患者中,术前CAD-RADS分类的预后价值
Kitae Kim1, Byeong A Yoo1, Hyun Jung Koo2
1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
The international journal of cardiovascular imaging
|February 24, 2025
概括
冠状动脉疾病报告和数据系统 (CAD-RADS) 的得分预测了大动脉置换 (AVR) 后的结果. 在AVR患者中,较高的CAD-RADS得分与死亡风险增加以及重大心脏和脑血管不良事件 (MACCE) 相相关.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 心血管外科心血管外科
背景情况:
- 大动脉置换 (AVR) 是对大动脉疾病的常见手术.
- 同时的冠状动脉疾病 (CAD) 可以影响AVR后的结果.
- 准确的手术前评估CAD严重程度对于风险分层至关重要.
研究的目的:
- 通过CAD-RADS分类的术前冠状动脉疾病 (CAD) 严重程度与接受单独AVR的患者的临床结果之间的关联进行评估.
- 确定CAD-RADS评分是否可以预测该患者群体的全因死亡和MACCE.
主要方法:
- 对897名接受了分离AVR和术前冠状动脉计算机断层扫描血管学 (CCTA) 的患者进行了回顾性分析.
- 患者根据CAD-RADS得分 (0-4) 进行了分层.
- 评估的结果包括全因死亡和MACCE,使用生存分析和调整后的Cox回归来分析.
主要成果:
- CAD-RADS得分显示,所有死因的死亡率和得分较高的MACCE增加的趋势.
- 经调整后,CAD-RADS得分≥3与所有死因 (HR 2.44) 和MACCE (HR 1.79) 的风险增加显著相关.
- 与冠状动脉血管造影 (CAG) 一起接受医学治疗的CAD-RADS≥3患者的生存率有所改善.
结论:
- 手术前的CCTA和CAD-RADS评估对于识别并发性CAD和预测隔离AVR患者的长期结果是有价值的.
- 患有CAD-RADS≥3的患者需要谨慎管理,包括考虑与CAG结合的药物治疗或干预.
- CAD-RADS评分可以帮助对AVR患者进行个性化风险评估和治疗计划.
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