Department of Cardiology, Hacettepe University, Ankara, Turkey.
Atherosclerosis. 2010 Nov;213(1):178-83. doi: 10.1016/j.atherosclerosis.2010.08.077. Epub 2010 Sep 21.
In this study, we aimed to evaluate whether serum uric acid (UA) was associated with the severity and morphology of coronary atherosclerotic plaques (CAP) shown by multidetector computed tomography (MDCT). The study population consisted of 982 patients (58% men) who underwent dual-source 64 slice MDCT for the assessment of coronary artery disease (CAD). Coronary arteries were evaluated on 16 segment basis and critical coronary plaque was described as luminal narrowing >50%, whereas plaque morphology was assessed on per segment basis. Serum UA levels were determined using commercially available assay kits. The critical atherosclerotic lesions were detected in 454/982 (46.2%) subjects by MDCT. Serum UA levels were found to be higher in patients with any coronary plaque (6.9 ± 1.5mg/dL vs. 5.1 ± 1.3mg/dL, p<0.01). Also UA level was higher in patients with critical stenosis compared to non-critical stenosis (6.1 ± 1.5mg/dL vs. 5.4 ± 1.3mg/dL, p<0.001). Subjects having primarily calcified plaques have higher UA levels compared to other plaque subtypes (5.5 ± 1.3 for non-calcified plaques, and 5.6 ± 1.2 for mixed plaques, 6.6 ± 1.6 for calcified plaques, p<0.001). This independent association was remained after multinominal regression analysis (OR: 1,987; 95% CI; 1.69-2.32; p<0.01). Our study demonstrated that serum UA level was significantly associated with the severity and the calcified morphology of CAP detected by MDCT. Further prospective clinical studies are needed to clarify the exact physiopathologic role of UA in CAD.
在这项研究中,我们旨在评估血清尿酸(UA)是否与多排螺旋 CT(MDCT)显示的冠状动脉粥样硬化斑块(CAP)的严重程度和形态有关。研究人群由 982 名(58%为男性)接受双源 64 层 MDCT 评估冠心病(CAD)的患者组成。冠状动脉按 16 节段进行评估,临界冠状动脉斑块定义为管腔狭窄>50%,斑块形态按节段进行评估。使用商业上可获得的测定试剂盒测定血清 UA 水平。MDCT 检测到 454/982(46.2%)患者存在临界粥样硬化病变。发现患有任何冠状动脉斑块的患者血清 UA 水平较高(6.9±1.5mg/dL 比 5.1±1.3mg/dL,p<0.01)。与非临界狭窄相比,临界狭窄患者的 UA 水平也较高(6.1±1.5mg/dL 比 5.4±1.3mg/dL,p<0.001)。与其他斑块亚型相比,主要钙化斑块患者的 UA 水平较高(非钙化斑块为 5.5±1.3,混合斑块为 5.6±1.2,钙化斑块为 6.6±1.6,p<0.001)。多元回归分析后,这种独立相关性仍然存在(OR:1.987;95%CI;1.69-2.32;p<0.01)。我们的研究表明,血清 UA 水平与 MDCT 检测到的 CAP 的严重程度和钙化形态显著相关。需要进一步的前瞻性临床研究来阐明 UA 在 CAD 中的确切病理生理作用。