Ilangkovan Nivethitha, Mogensen Christian Backer, Mickley Hans, Lassen Annmarie Touborg, Lambrechtsen Jess, Sand Niels Peter Ronnow, Albiniussen Rasmus, Byg Jørgen, Steffensen Flemming Hald, Grønhøj Mette Hjortdal, Diederichsen Axel
Cardiology Department, Hospital of Southern Denmark, Aabenraa, Denmark.
Emergency Department, Hospital of Southern Denmark, Aabenraa, Denmark.
BMJ Open. 2018 Mar 3;8(3):e018391. doi: 10.1136/bmjopen-2017-018391.
To examine and compare the prevalence of coronary artery calcification (CAC) and the frequency of cardiac events in a background population and a cohort of patients with non-specific chest pain (NSCP) who present to an emergency or cardiology department and are discharged without an obvious reason for their symptom.
A double-blinded, prospective, observational cohort study that measures both CT-determined CAC scores and cardiac events after 1 year of follow-up.
Emergency and cardiology departments in the Region of Southern Denmark.
In total, 229 patients with NSCP were compared with 722 patients from a background comparator population.
Prevalence of CAC and incidence of unstable angina (UAP), acute myocardial infarction (MI), ventricular tachycardia (VT), coronary revascularisation and cardiac-related mortality 1 year after index contact.
There was no significant difference in the prevalence of CAC (OR 0.9 (95% CI 0.6 to 1.3), P=0.546) or the frequency of cardiac endpoints (P=0.64) between the studied groups. When compared with the background population, the OR for patients with NSCP for a CAC >100 Agatston units (AU) was 1.0 (95% CI 0.6 to 1.5), P=0.826. During 1 year of follow-up, two (0.9%) patients with NSCP underwent cardiac revascularisation, while none experienced UAP, MI, VT or death. In the background population, four (0.6%) participants experienced a clinical cardiac endpoint; two had an MI, one had VT and one had a cardiac-related death.
The prevalence of CAC (CAC >0 AU) among patients with NSCP is comparable to a background population and there is a low risk of a cardiac event in the first year after discharge. A CAC study does not provide notable clinical utility for risk-stratifying patients with NSCP.
NCT02422316; Pre-results.
研究并比较在普通人群以及因非特异性胸痛（NSCP）就诊于急诊科或心内科、症状无明显原因且出院的患者队列中冠状动脉钙化（CAC）的患病率和心脏事件的发生频率。
一项双盲、前瞻性观察性队列研究，在随访1年后测量CT确定的CAC评分和心脏事件。
丹麦南部地区的急诊科和心内科。
总共将229例NSCP患者与722例来自普通对照人群的患者进行比较。
指数接触后1年时CAC的患病率以及不稳定型心绞痛（UAP）、急性心肌梗死（MI）、室性心动过速（VT）、冠状动脉血运重建和心脏相关死亡率的发生率。
研究组之间在CAC患病率（比值比[OR]0.9[95%置信区间（CI）0.6至1.3]，P = 0.546）或心脏终点事件发生频率（P = 0.64）方面无显著差异。与普通人群相比，NSCP患者CAC>100阿加斯顿单位（AU）的OR为1.0（95%CI 0.6至1.5），P = 0.826。在1年的随访期间，2例（0.9%）NSCP患者接受了心脏血运重建，而无患者发生UAP、MI、VT或死亡。在普通人群中，4例（0.6%）参与者发生了临床心脏终点事件；2例发生MI，1例发生VT，1例发生心脏相关死亡。
NSCP患者中CAC（CAC>0 AU）的患病率与普通人群相当，出院后第一年发生心脏事件的风险较低。CAC研究对NSCP患者进行风险分层并无显著临床实用价值。
NCT02422316；预结果。
