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接受冠状动脉搭桥手术的日本冠心病患者的颈动脉狭窄和外周动脉疾病

Carotid stenosis and peripheral artery disease in Japanese patients with coronary artery disease undergoing coronary artery bypass grafting.

作者信息

Kawarada Osami, Yokoi Yoshiaki, Morioka Nobuyuki, Nakata Shinji, Higashiue Shinichi, Mori Toshifumi, Iwahashi Masahiro, Hatada Atsutoshi

机构信息

Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan.

出版信息

Circ J. 2003 Dec;67(12):1003-6. doi: 10.1253/circj.67.1003.

Abstract

The combination of a change in lifestyle toward Western habits and an aging society, has led to a steady increase in the incidence of atherosclerotic diseases in the Japanese population. Coronary artery disease (CAD), carotid stenosis (CS), and peripheral artery disease (PAD) are major manifestations of generalized atherosclerosis and increase the risk of cardiovascular events. However, the incidence of CS and PAD in Japanese patients with CAD is not well known, so the present study investigated this in 380 consecutive patients with CAD undergoing elective coronary aorta bypass grafting (CABG) at Kishiwada Tokushukai Hospital between October 1999 and October 2001. The coexistence of CS and PAD in all patients was preoperatively evaluated by duplex ultrasonography and the ankle - brachial index (ABI). The average age of the study population was 66.09.1 years (range, 42-87). The number of male patients was 293 (77.1%). The incidence of CS was 13.7% and 15.3% for PAD. Multivariate logistic regression analysis demonstrated that no particular traditional atherosclerotic risk factor, such as hypertension, hyperlipidemia, diabetes mellitus, and smoking, was able to predict either CS or PAD, but CS and PAD were independent predictors of each other. The results of the study suggest that CS and PAD were not only highly prevalent but also strongly associated with each other in this cohort of CAD patients. Accordingly, extracoronary atherosclerotic disease should be assessed in Japanese CAD patients.

摘要

生活方式向西方习惯转变以及社会老龄化的共同作用,导致日本人群中动脉粥样硬化疾病的发病率稳步上升。冠状动脉疾病(CAD)、颈动脉狭窄(CS)和外周动脉疾病(PAD)是全身性动脉粥样硬化的主要表现,会增加心血管事件的风险。然而,日本CAD患者中CS和PAD的发病率尚不清楚,因此本研究对1999年10月至2001年10月期间在岸和田德洲会医院连续接受择期冠状动脉搭桥术(CABG)的380例CAD患者进行了调查。术前通过双功超声和踝臂指数(ABI)对所有患者CS和PAD的共存情况进行评估。研究人群的平均年龄为66.0±9.1岁(范围42 - 87岁)。男性患者有293例(77.1%)。CS的发病率为13.7%,PAD的发病率为15.3%。多因素逻辑回归分析表明,没有任何特定的传统动脉粥样硬化危险因素,如高血压、高脂血症、糖尿病和吸烟,能够预测CS或PAD,但CS和PAD相互之间是独立的预测因素。研究结果表明,在这组CAD患者中,CS和PAD不仅高度普遍,而且相互之间密切相关。因此,对于日本CAD患者,应评估其冠状动脉外的动脉粥样硬化疾病。

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