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评估动脉粥样硬化性心血管疾病风险评分与颈动脉影像学检查结果之间的关系。

Assessing the Relationship between Atherosclerotic Cardiovascular Disease Risk Score and Carotid Artery Imaging Findings.

机构信息

Department of Radiology, Neuroradiology Section, Stanford University School of Medicine, Palo Alto, CA.

Department of Neurology, PLA Army General Hospital, Beijing, China.

出版信息

J Neuroimaging. 2019 Jan;29(1):119-125. doi: 10.1111/jon.12573. Epub 2018 Oct 25.

Abstract

BACKGROUND AND PURPOSE

To characterize the relationship between computed tomography angiography (CTA) imaging characteristics of carotid artery and the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) score.

METHODS

We retrospectively identified all patients who underwent a cervical CTA at our institution from January 2013 to July 2016, extracted clinical information, and calculated the 10-year ASCVD score using the Pooled Cohort Equations from the 2013 ACC/AHA guidelines. We compared the imaging features of artery atherosclerosis derived from the CTAs between low and high risk.

RESULTS

One hundred forty-six patients met our inclusion criteria. Patients with an ASCVD score ≥7.5% (64.4%) had significantly more arterial stenosis than patients with an ASCVD score <7.5% (35.6%, P < .001). Maximal plaque thickness was significantly higher (mean 2.33 vs. .42 mm, P < .001) and soft plaques (55.3% vs. 13.5%, P < .001) were significantly more frequent in patients with an ASCVD score ≥7.5%. However, among patients with a 10-year ASCVD score ≥7.5%, 33 (35.1%) had no arterial stenosis, 35 (37.2%) had a maximal plaque thickness less than. 9 mm, and 42 (44.7%) had no soft plaque. Furthermore, among the patients with a 10-year ASCVD score <7.5%, 8 (15.4%) had some arterial stenosis, 8 (15.4%) had a maximal plaque thickness more than. 9 mm, and 7 (13.5%) had soft plaque.

CONCLUSION

There is some concordance but not a perfect overlap between the 10-year ASCVD risk scores calculated from clinical and blood assessment and carotid artery imaging findings.

摘要

背景与目的

描述颈动脉计算机断层血管造影(CTA)影像学特征与 10 年动脉粥样硬化性心血管疾病(ASCVD)风险评分之间的关系。

方法

我们回顾性地从 2013 年 1 月至 2016 年 7 月在我们机构进行颈 CTA 的所有患者中提取临床信息,并使用 2013 年 ACC/AHA 指南中的汇总队列方程计算 10 年 ASCVD 评分。我们比较了低风险和高风险患者 CTA 得出的动脉粥样硬化影像学特征。

结果

符合纳入标准的患者共 146 例。ASCVD 评分≥7.5%(64.4%)的患者动脉狭窄程度明显高于 ASCVD 评分<7.5%(35.6%)的患者(P<.001)。最大斑块厚度明显较高(平均值 2.33mm 比.42mm,P<.001),且软斑块(55.3%比 13.5%,P<.001)在 ASCVD 评分≥7.5%的患者中更为常见。然而,在 ASCVD 评分≥7.5%的患者中,有 33 例(35.1%)无动脉狭窄,35 例(37.2%)最大斑块厚度<0.9mm,42 例(44.7%)无软斑块。此外,在 ASCVD 评分<7.5%的患者中,有 8 例(15.4%)有一些动脉狭窄,8 例(15.4%)最大斑块厚度>0.9mm,7 例(13.5%)有软斑块。

结论

从临床和血液评估以及颈动脉影像学检查得出的 10 年 ASCVD 风险评分之间存在一定的一致性,但并不完全重叠。

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