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稳定型心绞痛患者局部颈动脉僵硬度和炎症生物标志物的评估

Evaluation of local carotid stiffness and inflammatory biomarkers in stable angina pectoris.

作者信息

Aslan Abdullah Nabi, Özcan Ayşe Nur, Ayhan Hüseyin, Sivri Serkan, Çelebi Filiz, Ercan Karabekir, Durmaz Tahir

机构信息

Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey.

Department of Radiology, Atatürk Education and Research Hospital, Ankara, Turkey.

出版信息

Postepy Kardiol Interwencyjnej. 2017;13(2):122-129. doi: 10.5114/pwki.2017.68046. Epub 2017 May 30.

Abstract

INTRODUCTION

Arterial stiffness (AS) is a well-accepted and reliable predictor of atherosclerotic diseases. Inflammation plays an important role in the development of AS.

AIM

To evaluate local carotid stiffness (CS) together with fibrinogen and high-sensitivity C-reactive protein (hsCRP) levels in stable angina pectoris (SAP) patients.

MATERIAL AND METHODS

The study consisted of 353 consecutive patients with SAP. All underwent coronary angiography (CAG) after the evaluation of local CS parameters and carotid intima-media thickness (IMT) from both common carotid arteries by a real-time echo-tracking system. Baseline inflammatory biomarkers, serum hsCRP and fibrinogen levels were measured. Based on CAG findings, the patients were classified into 4 groups: control subjects with normal coronary arteries (group 1, = 86), single-vessel disease (group 2, = 104), double-vessel disease (group 3, = 95) and triple-vessel disease (group 4, = 68).

RESULTS

The mean carotid pulse wave velocity (PWV) in patients with angiographically confirmed coronary artery disease (CAD) was significantly higher than that in patients with normal coronary arteries (7.82 ±1.76 vs. 6.51 ±0.85 cm/s, = 0.001). The mean carotid IMT was detected to be significantly higher in group 4 patients compared to those in group 1 ( < 0.001) and group 2 ( = 0.001). Significant correlations were observed between both inflammatory biomarkers and the number of diseased vessels and carotid PWV. Using multi-variate analysis, carotid stiffness, carotid IMT, hsCRP and fibrinogen were independently associated with the presence and extent of CAD.

CONCLUSIONS

Local CS, carotid IMT, hsCRP and fibrinogen levels are significant predictors of atherosclerotic burden and they may facilitate the identification of high-risk patients for the early diagnosis and prompt treatment of CAD.

摘要

引言

动脉僵硬度(AS)是动脉粥样硬化性疾病公认的可靠预测指标。炎症在AS的发展中起重要作用。

目的

评估稳定型心绞痛(SAP)患者的局部颈动脉僵硬度(CS)以及纤维蛋白原和高敏C反应蛋白(hsCRP)水平。

材料与方法

该研究纳入了353例连续的SAP患者。所有患者均通过实时回声跟踪系统评估局部CS参数和双侧颈总动脉的颈动脉内膜中层厚度(IMT)后,接受了冠状动脉造影(CAG)。测量了基线炎症生物标志物、血清hsCRP和纤维蛋白原水平。根据CAG结果,将患者分为4组:冠状动脉正常的对照组(第1组,n = 86)、单支血管病变组(第2组,n = 104)、双支血管病变组(第3组,n = 95)和三支血管病变组(第4组,n = 68)。

结果

血管造影证实患有冠状动脉疾病(CAD)的患者的平均颈动脉脉搏波速度(PWV)显著高于冠状动脉正常的患者(7.82±1.76 vs. 6.51±0.85 cm/s,P = 0.001)。检测发现第4组患者的平均颈动脉IMT显著高于第1组(P < 0.001)和第2组(P = 0.001)患者。观察到两种炎症生物标志物与病变血管数量及颈动脉PWV之间均存在显著相关性。采用多变量分析,颈动脉僵硬度、颈动脉IMT、hsCRP和纤维蛋白原与CAD的存在及程度独立相关。

结论

局部CS、颈动脉IMT、hsCRP和纤维蛋白原水平是动脉粥样硬化负担重要的预测指标,它们可能有助于识别高危患者,以便对CAD进行早期诊断和及时治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b74/5545659/2cde99c447f0/PWKI-13-30041-g001.jpg

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