Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, 400042, People's Republic of China.
J Thromb Thrombolysis. 2012 Nov;34(4):533-40. doi: 10.1007/s11239-012-0771-1.
To investigate the stenotic coexistence among coronary, renal and extracranial arteries and check the predictive value of stenosis between these arteries in Chinese patients. The stenosis of three arteries was evaluated by angiography in 1,228 Chinese patients with clinically diagnosed coronary artery disease (CAD) or high CAD risk factors. Based on the criteria of stenotic diameter of ≥50%, we found that the rate of stenosis for the coronary artery was highest (48.5%), extracranial artery stenosis rate was intermediate at 20.2% and the renal artery with the stenosis rate of 14.3% was the lowest. The stenotic coexistence rates were 14.3% between the coronary and extracranial arteries, 10.9 % between coronary and renal arteries, 10.1% between the extracranial and renal arteries, and only 2.69% among all three arteries. The stenosis predictive value of the coronary artery for extracranial or renal arteries was lower, but the non-stenosis predictive value was higher. The predictive value of extracranial or renal artery for coronary artery stenosis was higher, while the non-stenosis predictive value was lower. Both the stenosis and non-stenosis predictive values were higher between the extracranial and renal arteries. Cohen's Kappa value was less than 0.40 between coronary and extracrainal or renal artery but more than 0.40 between extracranial and renal artery. The results were similar when the criteria of stenosis were judged as ≥75 or ≥25% respectively. We also did analysis within the subgroups with hypertension, diabetes, stroke and transient ischemia attach, got similar results. For Chinese patients with clinically diagnosed CAD or with highly risk factors, non-stenosis of the coronary artery is indicative of reduced stenosis of the extracranial and renal arteries, while extracranial or renal arteries stenosis is indicative of increased coronary artery stenosis.
探讨中国人群冠状动脉、肾动脉和颅外动脉狭窄的共存情况，并检验这些动脉之间狭窄的预测价值。
通过血管造影评估 1228 例临床诊断为冠心病（CAD）或具有高危 CAD 因素的中国患者的三支动脉狭窄情况。基于狭窄直径≥50%的标准，我们发现冠状动脉狭窄率最高（48.5%），颅外动脉狭窄率次之（20.2%），肾动脉狭窄率最低（14.3%）。冠状动脉与颅外动脉狭窄共存率为 14.3%，冠状动脉与肾动脉狭窄共存率为 10.9%，颅外动脉与肾动脉狭窄共存率为 10.1%，三支动脉均狭窄的比例仅为 2.69%。冠状动脉狭窄对颅外动脉或肾动脉狭窄的预测价值较低，但对非狭窄的预测价值较高。颅外动脉或肾动脉狭窄对冠状动脉狭窄的预测价值较高，但对非狭窄的预测价值较低。颅外动脉与肾动脉狭窄和非狭窄的预测价值均较高。冠状动脉与颅外动脉或肾动脉之间的 Cohen's Kappa 值小于 0.40，但颅外动脉与肾动脉之间的 Cohen's Kappa 值大于 0.40。当狭窄标准分别判断为≥75%或≥25%时，结果相似。我们还对高血压、糖尿病、卒中和短暂性脑缺血发作亚组进行了分析，得到了相似的结果。对于临床诊断为 CAD 或具有高危因素的中国患者，冠状动脉非狭窄提示颅外动脉和肾动脉狭窄程度降低，而颅外动脉或肾动脉狭窄提示冠状动脉狭窄程度增加。
