摘要
目的探讨急性冠状动脉综合征(ACS)总冠状动脉钙化(CAC)负荷和局部CAC与主要病变之间的关系。方法对37例ACS患者及223例对照患者进行计算机CAC检查和CT血管造影评估显著狭窄和高风险斑块的表现,测量总评分和节段Agatston评分。对ACS患者的主要病变进行评价。结果 37例ACS患者的CAC总评分较非ACS患者高[229(75,517)和27(0,99),P<0.01],具有更高的狭窄发生率(78.4%和7.2%,P<0.01)和高风险斑块(94.6%和58.7%,P<0.01)。在ACS患者中,罪犯血管(41例)与非罪犯血管(200例),具有相似的节段CAC评分[22.3(3.6,70.8)和14.1(0.3,51.1),P=0.372],但是前者具有更高的狭窄发生率(81.5%和10.5%,P<0.01)和高风险斑块(75.6%和51.0%,P=0.005);显著狭窄[OR(95%CI):32.0(9.6,106.1),P<0.01]和高风险斑块[OR(95%CI):3.3(1.3,9.1),P=0.02)]与急性冠状动脉综合征的罪魁祸首病变相关,但节段性冠心病评分[OR (95%CI):1.0(1.0.1.0),P=0.47]与急性冠状动脉综合征的罪魁祸首病变无相关。结论总CAC负荷与ACS相关,但节段性CAC与罪犯病变无关。总的而非局部的CAC是ACS风险的标志,支持广泛的局部的CAC是斑块稳定性的标志的假设。
Objective To determine the differences between total CAC with acute coronary syndrome(ACS and local CAC with culprit lesions in patients with suspected ACS. Methods Computed tomography(CT) for CAC and CT angiography were performed to assess the presence of significant stenosis and high-risk plaque(positive remodeling,low CT attenuation, napkin-ring sign,spotty calcium) in 37 patients with ACS and 223 controls.Total and segmental Agatston score were measured. Culprit lesions were assessed in subjects with ACS. Results As for 37 patients with ACS and those patients without ACS, ACS patients had higher total CAC score [229(75,517)vs 27(0,99),P <0.01],higher prevalence of significant stenosis(78.4% vs7.2%,P <0.01)and high-risk plaque(94.6% vs58.7%,P <0.01). In those with ACS, culprit(n =41) and non-culprit(n =200) lesions had similar segmental CAC score [22.3(3.6,70.8) vs 14.1(0.3,51.1),P=0.37],but the former had higher prevalence of significant stenosis(80.5% vs 10.5%,P<0.01) and high-risk plaque(75.6% vs 51.0%, P=0.005). Significant stenosis [OR(95%CI):32.0(9.6,106.1),P <0.01] and high-risk plaque [OR(95% CI):3.3(1.4,9.6),P =0.02], but segmental CAC score[OR(95%CI):1.0(1.0,1.0),P=0.47] were not associated with culprit lesions of ACS. Conclusion Total CAC burden was associated with ACS but segmental CAC was not associated with culprit lesions. Suggesting that total but not local CAC is a marker of ACS risk and support the hypothesis that extensive local CAC is a marker of plaque stability.
作者
陈华
赵施竹
Chen Hua;Zhao Shizhu(Department of ICU,Hebi Coal Industry Company General Hospital,Henan 458000,China;不详)
出处
《实用医学影像杂志》
2022年第1期38-43,共6页
Journal of Practical Medical Imaging
