肝移植接受者和人口对照中的冠状动脉样硬化:一项全国性的研究使用协议化CT血管学
Andreas Dehlbæk Knudsen1, Jørgen Tobias Kühl2, Nicolai Aagaard Schultz3
1Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Journal of the American College of Cardiology
|March 4, 2026
概括
与普通人群相比,肝移植接受者的冠状动脉样硬化率显著更高. 这凸显了在这个患者群体中需要主动评估心血管风险和预防策略的需要.
科学领域:
- 心脏病学 心脏病学
- 移植肝病学 移植肝病学
- 放射学 放射学是一门学科.
背景情况:
- 由于依赖有限的成像数据,肝移植 (LTx) 接受者的冠状动脉样硬化患病率和严重程度尚不清楚.
- 之前的研究经常使用临床指示或回顾性成像,缺乏标准化研究协议.
研究的目的:
- 调查LTx接受者的冠状动脉样硬化的患病率和严重程度.
- 为了比较LTx接受者的冠状动脉样硬化与使用标准化冠状动脉CT血管造影的匹配对照对象.
主要方法:
- 一项横截面研究将205名LTx接受者 (来自DACOLT研究) 与1025名人口对照 (来自哥本哈根总人口研究) 根据年龄和性别进行了匹配.
- 进行了标准化问卷,体检和冠状动脉CT血管造影.
- 冠状动脉样硬化被分为任何,阻塞性 (≥50%狭窄) 或广泛的 (>5段);经心血管风险因素调整后的后勤回归.
主要成果:
- 与对照组相比,LTx接受者表现出任何 (63%对46%),阻塞性 (18%对10%) 和阻塞性-扩展性 (13%对6%) 冠状动脉样硬化的更高患病率.
- 在调整后,LTx接受者对任何 (OR: 2.19),阻塞性 (OR: 2.73) 和阻塞性-扩展性 (OR: 3.90) 冠状动脉样硬化的几率显著增加.
- 患有冠状动脉样硬化的LTx接受者更有可能患有高风险斑块 (OR: 2.10).
结论:
- 肝移植患者的冠状动脉样硬化患病率和严重程度明显高于一般人群对照,即使考虑到传统的风险因素.
- 加强心血管风险评估和预防措施对LTx接受者至关重要.
- 这些发现源自丹麦肝移植受体共患病率研究 (DACOLT;NCT04777032).
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