Petisco Ana Claudia Gomes Pereira, Assef Jorge Eduardo, de Jesus Carlos Alberto, Saleh Mohamed Hassan, Barbosa Jose Eduardo Martins, Costa de Souza Le Bihan David, Pinto Ibraim Masciarelli França, Rolim Fernandes Fontes Pedra Simone, Barretto Rodrigo Bellio de Mattos, Sousa Amanda Guerra de Moraes Rego
Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
Int J Cardiovasc Imaging. 2017 Mar;33(3):401-410. doi: 10.1007/s10554-016-1002-1. Epub 2016 Oct 20.
Cardiovascular diseases are the leading cause of mortality among women in several countries. Early detection of subclinical atherosclerosis (SA) could enable the adoption of preventive measures to avoid cardiovascular events. This study aimed to determine the prevalence of SA in Brazilian asymptomatic postmenopausal women in Framingham Risk Score (FRS) low and intermediate groups. Computed tomography (CT) and ultrasound (US) scans were performed in 138 asymptomatic postmenopausal women (56.1 ± 4.9 years of age) to survey for coronary artery and aortic calcification (CT scan) and assess carotid intima-media thickness (CIMT) and identify carotid plaques (US). The mean FRS was 2.64 ± 2.13 %. The prevalence of increased CIMT, carotid plaques, increased CIMT and/or plaques, coronary artery calcification (CAC) >0 and aortic calcification (AC) were, respectively, 45.7, 37.7, 62.3, 23.9 and 45.7 %. Normal imaging tests were found in 22.4 %. SA, defined as at least one abnormal imaging test, was associated with age, FRS, waist-to-rip ratio, systolic and diastolic blood pressure, HDL-c and ApoA1 levels, and ApoA1/ApoB ratio. In logistic regression, SA was associated with higher age (OR 1.108, 95 % CI 1.010-1.215, p = 0.029) and lower ApoA1 levels (OR 0.979, 95 % CI 0.960-0.998, p = 0.029). SA was prevalent in Brazilian postmenopausal women with low and intermediate risk groups (FRS) and was associated with higher age and lower levels of ApoA1. Carotid atherosclerosis was the most common presentation of SA in this group.
在一些国家，心血管疾病是女性死亡的主要原因。早期发现亚临床动脉粥样硬化（SA）有助于采取预防措施以避免心血管事件的发生。本研究旨在确定巴西弗明汉风险评分（FRS）低、中风险组无症状绝经后女性中SA的患病率。对138名无症状绝经后女性（年龄56.1±4.9岁）进行计算机断层扫描（CT）和超声（US）检查，以检测冠状动脉和主动脉钙化（CT扫描），评估颈动脉内膜中层厚度（CIMT）并识别颈动脉斑块（US）。平均FRS为2.64±2.13%。CIMT增厚、颈动脉斑块、CIMT增厚和/或斑块、冠状动脉钙化（CAC）>0以及主动脉钙化（AC）的患病率分别为45.7%、37.7%、62.3%、23.9%和45.7%。22.4%的检查结果正常。SA定义为至少一项影像学检查异常，其与年龄、FRS、腰臀比、收缩压和舒张压、高密度脂蛋白胆固醇（HDL-c）和载脂蛋白A1（ApoA1）水平以及ApoA1/ApoB比值相关。在逻辑回归分析中，SA与较高年龄（比值比[OR]1.108，95%置信区间[CI]1.010 - 1.215，p = 0.029）和较低ApoA1水平（OR 0.979，95%CI 0.960 - 0.998，p = 0.029）相关。SA在巴西FRS低、中风险组的绝经后女性中普遍存在，且与较高年龄和较低ApoA1水平相关。在该组中，颈动脉粥样硬化是SA最常见的表现形式。
