在接受初级预防评估的无症状患者中发现高风险的冠状动脉斑块和 Carotid Duplex
Lucio Addeo1, Pasquale Guarini2, Carlo Tedeschi3
1Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini, 80131 Naples, Italy.
Journal of cardiovascular development and disease
|February 26, 2026
概括
高危冠状动脉斑在无症状个体中很常见. 轻微的动脉动脉样硬化与高冠状动脉结合,可以识别那些易受损伤的斑块,这表明风险分层有所改善.
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:
- 亚临床冠状动脉样硬化是普遍存在的,但其攻击性和与无症状个体冠状动脉外疾病的联系尚不清楚.
- 评估高风险冠状动脉斑 (HRPs) 以及它们与动脉动脉样硬化和冠状动脉的关联对于初级预防至关重要.
研究的目的:
- 评估心血管高风险队列中HRPs的患病率及其与轻度动脉动脉样硬化和冠状动脉的关系.
- 在接受初级预防的无症状个体中确定斑块脆弱性的预测因素.
主要方法:
- 对269名无症状的成年人进行了回顾性多中心研究,这些成年人具有心血管风险因素.
- 冠状动脉计算机断层扫描血管扫描 (CCTA) 和冠状动脉双重超声波 (CDUS) 用于评估冠状动脉疾病 (CAD) 和冠状动脉样硬化.
- HRPs是由不利的形态特征定义的;CAD和心血管疾病被分级.
主要成果:
- 在31%的患者中,CAD缺席,在41%的患者中非阻塞性,在28%的患者中阻塞性. 在所有病例中的30.9%中发现了HRP.
- 在轻度心动动脉动脉样硬化 (CDUS 1-49%) 和高冠状动脉 (≥100 Agatston) 的结合下,HRP的患病率增加.
- 当前吸烟独立地预测了轻度动脉动脉样硬化 (OR 2.1) 患者的HRPs.
结论:
- 几乎三分之一的无症状高CV风险成年人有HRPs.
- 轻度动脉动脉样硬化和冠状动脉≥100协同识别HRPs的个体.
- 结合成像 (心血管超声波,评分,CCTA) 可能会增强主要预防风险分层,超出传统因素.
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