The Heart Center of Chonnam National University Hospital, Gwangju, Korea.
Am J Cardiol. 2010 Jul 1;106(1):38-43. doi: 10.1016/j.amjcard.2010.02.011. Epub 2010 May 13.
We used virtual histology and intravascular ultrasound (VH-IVUS) to evaluate the relation between aortic knob calcium (AKC) and plaque components in diabetic patients. The presence of AKC was assessed by posteroanterior view of chest x-ray or fluoroscopy at the time of coronary angiography. A total of 137 de novo coronary culprit lesions in 137 consecutive diabetic patients were studied and coronary plaque components were analyzed using VH-IVUS according to the presence (n = 45) or absence (n = 92) of AKC. Patients with AKC were significantly older (68 +/- 8 vs 62 +/- 9 years, p <0.001) and had significantly higher high-sensitivity C-reactive protein levels (1.97 +/- 1.33 vs 0.48 +/- 1.35 mg/dl, p = 0.005) compared to patients without AKC. Absolute and percent necrotic core (NC) volumes (30 +/- 26 vs 20 +/- 19 mm(3), p = 0.003; 23.4 +/- 10.3% vs 17.4 +/- 8.9%, p = 0.005, respectively) and absolute and percent dense calcium (DC) volumes (17 +/- 12 vs 11 +/- 12 mm(3), p = 0.010; 13.3 +/- 7.3% vs 9.6 +/- 7.9%, p = 0.011, respectively) were significantly greater in lesions with AKC compared to those without AKC. Multivariable analysis showed that age (odds ratio [OR] 1.233, 95% confidence interval [CI] 1.121 to 1.355, p <0.001), high-sensitivity C-reactive protein (OR 1.871, 95% CI 1.090 to 2.943, p = 0.007), absolute DC volume (OR 1.020, 95% CI 1.050 to 1.178, p = 0.003), and absolute NC volume (OR 1.026, 95% CI 1.057 to 1.199, p <0.001) were independent predictors of AKC. In conclusion, diabetic patients with AKC were older, had greater NC- and DC-containing plaques, and higher inflammatory status compared to diabetic patients without AKC.
我们使用虚拟组织学和血管内超声（VH-IVUS）来评估主动脉结钙（AKC）与糖尿病患者斑块成分之间的关系。在冠状动脉造影时，通过前后位胸部 X 射线或透视评估 AKC 的存在。共研究了 137 例连续糖尿病患者的 137 个新发病变的冠状动脉罪犯病变，并根据 AKC 的存在（n = 45）或不存在（n = 92），使用 VH-IVUS 分析冠状动脉斑块成分。AKC 患者明显更年长（68 ± 8 岁 vs 62 ± 9 岁，p <0.001），高敏 C 反应蛋白水平明显更高（1.97 ± 1.33 vs 0.48 ± 1.35 mg/dl，p = 0.005）。与无 AKC 的患者相比。绝对和百分比坏死核心（NC）体积（30 ± 26 vs 20 ± 19 mm3，p = 0.003；23.4 ± 10.3% vs 17.4 ± 8.9%，p = 0.005）和绝对和百分比致密钙（DC）体积（17 ± 12 vs 11 ± 12 mm3，p = 0.010；13.3 ± 7.3% vs 9.6 ± 7.9%，p = 0.011）在有 AKC 的病变中明显大于无 AKC 的病变。多变量分析显示，年龄（比值比[OR] 1.233，95%置信区间[CI] 1.121 至 1.355，p <0.001）、高敏 C 反应蛋白（OR 1.871，95% CI 1.090 至 2.943，p = 0.007）、绝对 DC 体积（OR 1.020，95% CI 1.050 至 1.178，p = 0.003）和绝对 NC 体积（OR 1.026，95% CI 1.057 至 1.199，p <0.001）是 AKC 的独立预测因素。总之，与无 AKC 的糖尿病患者相比，有 AKC 的糖尿病患者年龄更大，NC 和 DC 含量更高的斑块更多，炎症状态更高。
