Papanas N, Tziakas D, Mavridis G, Giannakis I, Symeonidis G, Stakos D, Milousis A, Maltezos E, Louridas G, Hatseras D
Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Acta Clin Belg. 2007 Jan-Feb;62(1):52-5. doi: 10.1179/acb.2007.008.
The aim of this study was to evaluate the sensitivity and specificity of aortic arch calcification for detection of severe coronary atherosclerosis in patients suffering from coronary artery disease (CAD), with or without type 2 diabetes.
This study included 107 type 2 diabetic patients (68 men) with a mean age of 62.4 +/- 10.7 years and a mean diabetes duration of 14.2 +/- 5.9 years and 104 patients (63 men) with a mean age of 64.5 +/- 9.3 years who did not have diabetes. All patients had CAD, documented by coronary arteriography. Severe CAD was defined as atherosclerosis of the left main branch or atherosclerosis of three coronary arteries or atherosclerosis of the proximal part of the left anterior descending artery. Aortic arch calcification was assessed by means of posteroanterior chest X-rays, studied by a radiologist kept blind to the result of coronary arteriography.
In type 2 diabetic patients, diagnosis of aortic arch calcification had 65.6% sensitivity and 86.9% specificity for detection of severe CAD. In patients without diabetes, diagnosis of aortic arch calcification had 47.7% sensitivity and 96.7% specificity for detection of severe CAD.
Aortic arch calcification has a high specificity for detection of severe coronary atherosclerosis in patients with CAD. Sensitivity is higher in patients with type 2 diabetes, while specificity is slightly higher in non-diabetic patients.
本研究旨在评估主动脉弓钙化对冠心病(CAD)患者(无论有无2型糖尿病)严重冠状动脉粥样硬化检测的敏感性和特异性。
本研究纳入107例2型糖尿病患者(68例男性),平均年龄62.4±10.7岁,平均糖尿病病程14.2±5.9年,以及104例无糖尿病患者(63例男性),平均年龄64.5±9.3岁。所有患者均经冠状动脉造影证实患有CAD。严重CAD定义为左主干分支粥样硬化或三支冠状动脉粥样硬化或左前降支近端粥样硬化。通过后前位胸部X线评估主动脉弓钙化,由对冠状动脉造影结果不知情的放射科医生进行分析。
在2型糖尿病患者中,主动脉弓钙化诊断对严重CAD检测的敏感性为65.6%,特异性为86.9%。在无糖尿病患者中,主动脉弓钙化诊断对严重CAD检测的敏感性为47.7%,特异性为96.7%。
主动脉弓钙化对CAD患者严重冠状动脉粥样硬化检测具有较高特异性。2型糖尿病患者的敏感性较高,而非糖尿病患者的特异性略高。