冠状动脉钙评分在他汀类药物获益人群无症状个体的心血管风险分层中发挥着重要作用。

Coronary artery calcium score plays an important role for cardiovascular risk stratification in the statin benefit groups of asymptomatic individuals.

机构信息

Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, #505 Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea.

Division of Cardiology, Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, #505 Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea.

出版信息

Lipids Health Dis. 2017 Sep 12;16(1):172. doi: 10.1186/s12944-017-0560-0.

DOI:10.1186/s12944-017-0560-0

PMID:28899385

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5596478/

Abstract

BACKGROUND

The purpose of this study was to describe and analyze the relationship between statin benefit groups based on statin-intensity class of drugs and coronary artery calcium score (CACS) using multidetector computed tomography (MDCT) in an asymptomatic Korean population.

METHODS

A total of 3914 asymptomatic individuals (mean age: 55 ± 10 years; male: female = 2649: 1265) who underwent MDCT for health examination between January 2009 and December 2012 were retrospectively enrolled. They were categorized into three groups based on statin-intensity class of drugs (high-intensity (n = 1284, 32.8%); moderate-intensity (n = 1602, 40.9%) and low-intensity (n = 931, 23.8%) statin therapy groups) according to the American College of Cardiology (ACC)/American heart Association (AHA) 2013 guideline and the relationship between CACS and statin benefit group was analyzed. The statin benefit group was defined as individuals who should be considered moderate- and high-intensity statin therapy.

RESULTS

Ten-year atherosclerotic cardiovascular disease (ASCVD; 12.6 ± 5.3% vs. 2.9 ± 1.9%, p < 0.001) and CACS (98 ± 270 vs. 3 ± 2, p < 0.001) were significantly higher in the high-intensity group compared to the moderate-intensity statin therapy group. In the high-intensity statin therapy group, age [odds ratio: 1.299 (1.137-1.483), p < 0.001], male gender [odds ratio: 44.252 (1.959-999.784), p = 0.001], and fasting blood glucose [odds ratio: 1.046 (1.007-1.087), p = 0.021] were independent risk factors associated with CACS ≥300 on multivariate logistic regression analysis.

CONCLUSIONS

CACS on MDCT might be an important complementary tool for cardiovascular disease risk stratification. This study indicates that individualization of statin therapy as well as lifestyle modification will be useful in asymptomatic individuals, especially those in whom high-intensity statin therapy is required.

摘要

背景

本研究旨在使用多排螺旋 CT（MDCT）描述和分析在无症状韩国人群中基于他汀类药物强度类别（药物强度）的他汀类药物获益组与冠状动脉钙评分（CACS）之间的关系。

方法

回顾性纳入 2009 年 1 月至 2012 年 12 月期间因健康体检而接受 MDCT 的 3914 名无症状个体（平均年龄：55±10 岁；男性：女性=2649:1265）。根据美国心脏病学会（ACC）/美国心脏协会（AHA）2013 指南，根据他汀类药物强度类别（高强度他汀类药物治疗组（n=1284，32.8%）、中强度他汀类药物治疗组（n=1602，40.9%）和低强度他汀类药物治疗组（n=931，23.8%）将他们分为三组，并分析 CACS 与他汀类药物获益组之间的关系。他汀类药物获益组被定义为需要考虑中高强度他汀类药物治疗的个体。

结果

与中强度他汀类药物治疗组相比，高强度他汀类药物治疗组的 10 年动脉粥样硬化性心血管疾病（ASCVD；12.6±5.3%比 2.9±1.9%，p<0.001）和 CACS（98±270 比 3±2，p<0.001）明显更高。在高强度他汀类药物治疗组中，年龄[比值比：1.299（1.137-1.483），p<0.001]、男性[比值比：44.252（1.959-999.784），p=0.001]和空腹血糖[比值比：1.046（1.007-1.087），p=0.021]是 CACS≥300 的多变量逻辑回归分析的独立危险因素。