Toutouzas Konstantinos, Benetos Georgios, Koutagiar Iosif, Barampoutis Nikolaos, Mitropoulou Fotini, Davlouros Periklis, Sfikakis Petros P, Alexopoulos Dimitrios, Stefanadis Christodoulos, Siores Elias, Tousoulis Dimitris
First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University Medical School, Athens, Greece.
First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University Medical School, Athens, Greece.
Atherosclerosis. 2017 Jul;262:25-30. doi: 10.1016/j.atherosclerosis.2017.04.019. Epub 2017 Apr 23.
Limited prospective data have been reported regarding the impact of carotid inflammation on cardiovascular events in patients with coronary artery disease (CAD). Microwave radiometry (MWR) is a noninvasive, simple method that has been used for evaluation of carotid artery temperature which, when increased, predicts 'inflamed' plaques with vulnerable characteristics. We prospectively tested the hypothesis that increased carotid artery temperature predicts future cerebro- and cardiovascular events in patients with CAD.
Consecutive patients from 3 centers, with documented CAD by coronary angiography, were studied. In both carotid arteries, common carotid intima-media thickness and plaque thickness were evaluated by ultrasound. Temperature difference (ΔT), measured by MWR, was considered as the maximal temperature along the carotid artery minus the minimum; ΔT ≥0.90 °C was assigned as high. Major cardiovascular events (MACE, death, stroke, myocardial infarction or revascularization) were recorded during the following year.
In total, 250 patients were studied; of them 40 patients (16%) had high ΔT values in both carotid arteries. MACEs occurred in 30% of patients having bilateral high ΔT versus 3.8% in the remaining patients (p<0.001). Bilateral high ΔT was independently associated with increased one-year MACE rate (HR = 6.32, 95% CI 2.42-16.53, p<0.001, by multivariate cox regression hazard model). The addition of ΔT information on a baseline model based on cardiovascular risk factors and extent of CAD significantly increased the prognostic value of the model (c-statistic increase 0.744 to 0.845, p = 0.05) CONCLUSIONS: Carotid inflammation, detected by MWR, has an incremental prognostic value in patients with documented CAD.
关于颈动脉炎症对冠心病（CAD）患者心血管事件影响的前瞻性数据有限。微波辐射测量法（MWR）是一种无创、简单的方法，已用于评估颈动脉温度，当温度升高时，可预测具有易损特征的“炎症性”斑块。我们前瞻性地检验了这一假设，即颈动脉温度升高可预测CAD患者未来的脑血管和心血管事件。
对来自3个中心的连续患者进行研究，这些患者经冠状动脉造影证实患有CAD。通过超声评估双侧颈动脉的颈总动脉内膜中层厚度和斑块厚度。用MWR测量的温差（ΔT）被定义为沿颈动脉的最高温度减去最低温度；ΔT≥0.90°C被定义为高温。记录下一年发生的主要心血管事件（MACE，死亡、中风、心肌梗死或血运重建）。
总共研究了250例患者；其中40例患者（16%）双侧颈动脉的ΔT值较高。双侧ΔT值高的患者中有30%发生了MACE，而其余患者中这一比例为3.8%（p<0.001）。双侧ΔT值高与一年MACE发生率增加独立相关（多变量Cox回归风险模型显示，HR = 6.32，95%CI 2.42 - 16.53，p<0.001）。在基于心血管危险因素和CAD程度的基线模型中加入ΔT信息，显著提高了模型的预后价值（c统计量从0.744增加到0.845，p = 0.05）。结论：通过MWR检测到的颈动脉炎症在已确诊的CAD患者中具有额外的预后价值。
