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冠状动脉钙化积分对降低整体心血管风险的影响。

Effect of coronary artery calcium score on the reduction of global cardiovascular risk.

作者信息

Młynarska Agnieszka, Młynarski Rafał, Sosnowski Maciej

出版信息

Pol Arch Med Wewn. 2014;124(3):88-96. doi: 10.20452/pamw.2130. Epub 2014 Jan 24.

Abstract

INTRODUCTION

There are no studies evaluating an association between different coronary artery calcium scores (CACS) and reduction of traditional cardiovascular risk.

OBJECTIVES

The aim of the study was to evaluate the effect of coronary calcium scoring on the reduction of global cardiovascular risk.

PATIENTS AND METHODS

This was a prospective single-center study including 180 subjects (mean age, 58.8 years). Calcifications on computed tomography were calculated by 2 experts using the Agatston scale. Selected cardiovascular risk factors and medical procedures used in subjects were analyzed.

RESULTS

Invasive coronary angiography was performed in 60 patients (33.2%). It did not show significant coronary lesions in 26 patients (43.3%), while in the other 26 patients (43.3%), coronary angioplasty (stent implantation, balloon angioplasty) was performed. Eight subjects (13.3%) were referred for coronary artery bypass grafting (CABG), and the procedure was performed only in patients with a CACS of 400 AU and higher. Angioplasty was performed 10 times more often in these patients compared with patients with a CACS of 1 to 399 AU. A significant correlation between the CACS and cardiovascular risk was observed in relation to age, weight, and systolic and diastolic blood pressure.

CONCLUSIONS

Coronary calcium scoring allows to identify patients requiring invasive coronary angioplasty, or, in some cases, CABG, with greater precision. This can strengthen the role of the CACS as a complement to a classic evaluation of cardiovascular risk factors.

摘要

引言

目前尚无研究评估不同冠状动脉钙化评分(CACS)与传统心血管风险降低之间的关联。

目的

本研究旨在评估冠状动脉钙化评分对降低整体心血管风险的效果。

患者与方法

这是一项前瞻性单中心研究,纳入180名受试者(平均年龄58.8岁)。由2名专家使用阿加斯顿评分法计算计算机断层扫描上的钙化情况。分析了受试者所采用的选定心血管危险因素和医疗程序。

结果

60例患者(33.2%)接受了有创冠状动脉造影。其中26例患者(43.3%)未显示明显冠状动脉病变,而另外26例患者(43.3%)接受了冠状动脉血管成形术(支架植入、球囊血管成形术)。8名受试者(13.3%)被转诊进行冠状动脉旁路移植术(CABG),且该手术仅在CACS为400 AU及以上的患者中进行。与CACS为1至399 AU的患者相比,这些患者接受血管成形术的频率高出10倍。观察到CACS与心血管风险在年龄、体重以及收缩压和舒张压方面存在显著相关性。

结论

冠状动脉钙化评分能够更精确地识别需要进行有创冠状动脉血管成形术或在某些情况下需要进行CABG的患者。这可以强化CACS作为经典心血管危险因素评估补充手段的作用。

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