Gadelha Patricia S, Campos Josemberg M, Moraes Fernando, da F S Leão Mariana, Ferraz Alvaro A B
Division of Radiology, Real Hospital Português, Av. Agamenon Magalhães, Nº 4760, Recife, PE CEP: 52010-902 Brazil.
Division of Surgery, Hospital das Clínicas, Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235-Cidade Universitária, Recife, PE CEP: 50670-901 Brazil.
Springerplus. 2014 Apr 22;3:199. doi: 10.1186/2193-1801-3-199. eCollection 2014.
Obesity is an important cause of cardiovascular disease, especially coronary artery disease. Severely obese patients are particularly prone to this risk. The coronary artery calcium (CAC) score is a strong predictor of coronary heart disease and provides incremental information beyond traditional risk factors. We sought to determine the prevalence of abnormally high CAC scores in the preoperative setting among patients undergoing bariatric surgery and to establish risk predictors for higher scores.
We performed an observational study of 202 patients free of known coronary artery disease who were referred for bariatric surgery. In each patient, the presence of CAC was detected with computed tomography, and coronary risk variables were either measured or determined via questionnaire.
CAC was found in 14.4% of the overall population (26% of male and 10.5% of female patients). Participants with altered CAC scores were older (mean age, 46.8 years). The variables positively associated with an altered CAC score were older age, male sex, type 2 diabetes, hypertension, and hypercholesterolemia. Multivariate-adjusted analysis showed that age (OR, 1.11; 95% CI, 1.06-1.17; p = 0.001), male sex (OR, 4.17; 95% CI, 1.52-11.47; p = 0.006), and hypercholesterolemia (OR, 6.21; 95% CI, 1.81-21.29; p = 0.004) were most closely related to the presence of CAC.
Obese patients in the preoperative bariatric surgery setting have a high prevalence of abnormal CAC scores. Traditional risk factors play a important role in this scenario.
肥胖是心血管疾病尤其是冠状动脉疾病的重要病因。重度肥胖患者尤其容易面临这种风险。冠状动脉钙化（CAC）评分是冠心病的有力预测指标，能提供超越传统风险因素的增量信息。我们旨在确定接受减肥手术患者术前异常高CAC评分的患病率，并建立更高评分的风险预测指标。
我们对202例无已知冠状动脉疾病且被转诊接受减肥手术的患者进行了一项观察性研究。对每位患者，通过计算机断层扫描检测CAC的存在，并通过问卷测量或确定冠状动脉风险变量。
在总体人群中，14.4%发现有CAC（男性患者为26%，女性患者为10.5%）。CAC评分改变的参与者年龄更大（平均年龄46.8岁）。与CAC评分改变呈正相关的变量有年龄较大、男性、2型糖尿病、高血压和高胆固醇血症。多变量调整分析显示，年龄（比值比[OR]，1.11；95%置信区间[CI]，1.06 - 1.17；p = 0.001）、男性（OR，4.17；95% CI，1.52 - 11.47；p = 0.006）和高胆固醇血症（OR，6.21；95% CI，1.81 - 21.29；p = 0.004）与CAC的存在关系最为密切。
减肥手术术前的肥胖患者中，异常CAC评分的患病率较高。传统风险因素在这种情况下起重要作用。
