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通过计算机断层扫描血管造影术检测的冠状动脉斑块类型和负荷,与C反应蛋白无关。

Coronary plaque type and burden by computed tomography angiography without association to C-reactive protein.

作者信息

Navaravong Leenhapong, Steenson Carol, Sigurdsson Gardar

机构信息

Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Department of Radiology, University of Minnesota and Minneapolis VAMC, Minneapolis, Minnesota, USA.

出版信息

N Am J Med Sci. 2014 Jun;6(6):260-5. doi: 10.4103/1947-2714.134370.

Abstract

BACKGROUND

Contrast-enhanced computed tomography angiography (CTA) of the coronaries allows identification of plaques. Limited data exists on the relationship between C-reactive protein (CRP) and the plaque type or plaque burden detected by CTA.

AIMS

We studied relationship between CRP and coronary atherosclerosis.

MATERIALS AND METHODS

92 patients without history of coronary disease underwent coronary CTA for chest pain. Coronary arteries were evaluated with each detected plaque labeled as calcified, noncalcified or mixed. Logarithmic transformation was done on CRP values for statistical analysis.

RESULTS

1380 coronary segments were evaluated. The average age was 57 years (SE 1.0) and basal metabolic index (BMI) 28.9 kg/m2 (SE 0.5). Median CRP level was 2.75 mg/L (range 0.17-16.98). No association was found between CRP quartiles and plaque type. In stepwise multivariate analysis, only diabetes was associated with noncalcified plaque (P < 0.001). When calcified and mixed plaques were added to the model, age (P < 0.001), diabetes (P < 0.02), and statin use (P < 0.05) were associated with an increased number of plaques per subject. No association was found between log-CRP for any type of plaque.

CONCLUSION

There was no association between CRP and plaque type by CTA. Lack of association is likely due to limited spatial resolution and underestimation of noncalcified plaque burden by CTA.

摘要

背景

冠状动脉增强计算机断层血管造影(CTA)可识别斑块。关于C反应蛋白(CRP)与CTA检测到的斑块类型或斑块负荷之间的关系,现有数据有限。

目的

我们研究了CRP与冠状动脉粥样硬化之间的关系。

材料与方法

92例无冠心病病史的患者因胸痛接受冠状动脉CTA检查。对冠状动脉进行评估,将每个检测到的斑块标记为钙化、非钙化或混合性。对CRP值进行对数转换以进行统计分析。

结果

共评估了1380个冠状动脉节段。平均年龄为57岁(标准误1.0),基础代谢指数(BMI)为28.9kg/m²(标准误0.5)。CRP中位数水平为2.75mg/L(范围0.17 - 16.98)。未发现CRP四分位数与斑块类型之间存在关联。在逐步多变量分析中,仅糖尿病与非钙化斑块相关(P < 0.001)。当将钙化和混合斑块纳入模型时,年龄(P < 0.001)、糖尿病(P < 0.02)和他汀类药物使用(P < 0.05)与每位受试者的斑块数量增加相关。未发现任何类型斑块的对数CRP之间存在关联。

结论

CTA显示CRP与斑块类型之间无关联。缺乏关联可能是由于空间分辨率有限以及CTA对非钙化斑块负荷的低估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/692f/4083526/09805c64ce7d/NAJMS-6-260-g001.jpg

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