Lee Dong-Hyeon, Youn Ho-Joong, Jung Hae-Ok, Chang Kiyuk, Choi Yun-Seok, Jung Jung Im
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, #505 Banpo-dong, Seocho-gu, Seoul, 137-701 Korea.
Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, #505 Banpo-dong, Seocho-gu, Seoul, 137-701 Korea.
Clin Hypertens. 2017 Mar 2;23:6. doi: 10.1186/s40885-017-0062-4. eCollection 2017.
Although it is known that coronary computed tomographic angiography (CCTA) offers highly negative predictive value to exclude obstructive coronary lesions, the plaque pattern on CCTA has not been fully understood. The purpose of this study was to explore the difference of the plaque patterns on CCTA and to assess the cardiovascular risks in healthy subjects.
A total of 3914 subjects (mean age: 55 ± 10 years, M : F = 2649 : 1265) who underwent CCTA for health check-up between January 2009 and December 2012 were enrolled. According to coronary artery calcium score (CACS) and plaque pattern on CCTA, subjects were categorized into four groups (group 1: normal; group 2: "non-calcified" plaque; group 3: "calcified" plaque; group 4: mixed plaque). We analyzed cardiovascular risks and Framingham risk score (FRS) among the groups.
The incidence of each group was group 1 in 55.0% (2152/3914), group 2 in 5.1% (200/3914), group 3 in 8.2% (319/3914), and group 4 in 7.2% (280/3914), respectively. There was no difference of FRS among the groups (6.4 ± 6.4%; 6.5 ± 4.6%; 8.2 ± 5.8%; 7.7 ± 5.7% = 0.086). In multivariate analysis, HbA1c (OR = 2.285; 95%CI = 1.029 - 5.071; = 0.042) in group 2; age (OR = 1.115; 95%CI = 1.034 - 1.202; = 0.005) and smoking status (OR = 3.386; 95%CI = 1.124 - 10.202; = 0.030) in group 3; and age (OR = 1.054; 95%CI = 1.011 - 1.099; = 0.014) and hypertension (OR = 3.087; 95%CI = 1.536 - 6.202; = 0.001) in group 4 were independent factors.
Our data suggest that more individualized therapy for reduction of cardiovascular risks associated with plaque pattern on CCTA could be considered in healthy subjects.
尽管已知冠状动脉计算机断层扫描血管造影（CCTA）对排除阻塞性冠状动脉病变具有较高的阴性预测价值，但CCTA上的斑块模式尚未完全明确。本研究的目的是探讨CCTA上斑块模式的差异，并评估健康受试者的心血管风险。
纳入2009年1月至2012年12月期间因健康检查接受CCTA的3914名受试者（平均年龄：55±10岁，男∶女 = 2649∶1265）。根据冠状动脉钙化评分（CACS）和CCTA上的斑块模式，将受试者分为四组（第1组：正常；第2组：“非钙化”斑块；第3组：“钙化”斑块；第4组：混合斑块）。我们分析了各组之间的心血管风险和弗雷明汉风险评分（FRS）。
各组的发生率分别为第1组55.0%（2152/3914）、第2组5.1%（200/3914）、第3组8.2%（319/3914）和第4组7.2%（280/3914）。各组之间的FRS无差异（6.4±6.4%；6.5±4.6%；8.2±5.8%；7.7±5.7%，P = 0.086）。在多因素分析中，第2组中的糖化血红蛋白（HbA1c）（OR = 2.285；95%CI = 1.029 - 5.071；P = 0.042）；第3组中的年龄（OR = 1.115；95%CI = 1.034 - 1.202；P = 0.
