Icen Yahya Kemal, Koc Ayse Selcan, Sumbul Hilmi Erdem
1 Cardiology Department, Health Sciences University, Adana Health Practice and Research Center, Adana, Turkey.
2 Radiology Department, Health Sciences University, Adana Health Practice and Research Center, Adana, Turkey.
Angiology. 2019 Jul;70(6):561-566. doi: 10.1177/0003319718794833. Epub 2018 Aug 16.
The aim of this study was to evaluate the relationship between aortic intima-media thickness (aIMT) and coronary artery disease (CAD) severity in patients with non-ST-segment elevation myocardial infarction (NSTEMI). SYNTAX score (SS) was calculated. Patients were categorized into 2 main groups according to the SS: patient with high risk (SS ≥ 13) and low risk (SS < 13). Common carotid artery IMT (cIMT), common femoral artery IMT, and aIMT were measured with a high-resolution ultrasound Doppler system. We had 147 (52.9%) patients in the high-risk group and 132 patients in the low-risk group. Both cIMT and aIMT were significantly increased, and left ventricular ejection fraction (LVEF) was significantly lower in the high-risk group; aIMT (odds ratio [OR]: 1.272, P < .001), cIMT (OR: 1.239, P = .009), and LVEF (OR: 0.931, P = .002) were determined as independent predictors for the high-risk group. When the cutoff value was accepted as 1.25 mm for the aIMT, patients with high SS identification had 74.1% sensitivity and 89.4% specificity (area under the curve: 0.764, P < .001). In conclusion, aIMT detected by abdominal B-mode ultrasonography is closely associated with CAD severity in patients with NSTEMI.
本研究旨在评估非ST段抬高型心肌梗死(NSTEMI)患者的主动脉内膜中层厚度(aIMT)与冠状动脉疾病(CAD)严重程度之间的关系。计算SYNTAX评分(SS)。根据SS将患者分为2个主要组:高危患者(SS≥13)和低危患者(SS<13)。使用高分辨率超声多普勒系统测量颈总动脉内膜中层厚度(cIMT)、股总动脉内膜中层厚度和aIMT。高危组有147例(52.9%)患者,低危组有132例患者。高危组的cIMT和aIMT均显著增加,左心室射血分数(LVEF)显著降低;aIMT(优势比[OR]:1.272,P<.001)、cIMT(OR:1.239,P=.009)和LVEF(OR:0.931,P=.002)被确定为高危组的独立预测因素。当aIMT的截断值设定为1.25 mm时,高SS识别的患者敏感性为74.1%,特异性为89.4%(曲线下面积:0.764,P<.001)。总之,腹部B型超声检测到的aIMT与NSTEMI患者的CAD严重程度密切相关。