Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America.
Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America.
PLoS One. 2018 Dec 12;13(12):e0203514. doi: 10.1371/journal.pone.0203514. eCollection 2018.
BACKGROUND/OBJECTIVES: Previous studies have demonstrated that in acute coronary syndrome (ACS), plaque destabilization and vessel inflammation, represented by vessel edema, often occur simultaneously in multiple coronaries, as well as extend to the cerebrovascular system. Our aim was to determine whether the inflammatory vascular processes occurring within the coronaries during ACS extend simultaneously to the descending aorta.
We prospectively enrolled 111 patients (56 ACS patients and 55 non-ACS patients with known coronary artery disease) to undergo cardiac magnetic resonance of the thoracic aortic wall at presentation and at three-month follow-up. The primary outcome was change in aortic wall area (AWA) and maximal aortic wall thickness (AWT) from baseline to three-month follow-up. Secondary outcomes were baseline and follow-up differences in AWA and AWT, and changes in C-reactive protein (CRP).
There was a significant reduction in mean AWA (p = 0.01) and AWT (p = 0.01) between index and follow up scans in ACS group, with no significant changes in non ACS group (both p>0.1) and no difference between ACS and non-ACS groups (p = 0.22). There was no significant difference in AWA and AWT at baseline (p>0.36) and follow-up (p>0.2) between groups. There was a significant reduction in CRP in both groups (p<0.01), with higher reduction in ACS patients (p<0.01).
There was a reduction in aortic wall size, aortic wall area, and aortic wall thickness in patients presenting with ACS, and no change in non-ACS patients. There were no interval between-group differences in these measurements. We observed a reduction in C-reactive protein in both groups, with higher reduction noted in ACS patients.
背景/目的：先前的研究表明，在急性冠状动脉综合征（ACS）中，斑块不稳定和血管炎症（表现为血管水肿）通常同时发生在多个冠状动脉中，并延伸至脑血管系统。我们的目的是确定 ACS 期间冠状动脉内发生的炎症性血管过程是否同时延伸至降主动脉。
我们前瞻性纳入了 111 名患者（56 名 ACS 患者和 55 名已知患有冠状动脉疾病的非 ACS 患者），在发病时和三个月随访时进行了胸部主动脉壁的心脏磁共振检查。主要结局是从基线到三个月随访时主动脉壁面积（AWA）和最大主动脉壁厚度（AWT）的变化。次要结局是 AWA 和 AWT 的基线和随访差异，以及 C 反应蛋白（CRP）的变化。
ACS 组在指数扫描和随访扫描之间，AWA（p = 0.01）和 AWT（p = 0.01）均显著降低，而非 ACS 组无显著变化（两者均 p>0.1），ACS 组与非 ACS 组之间无差异（p = 0.22）。两组之间的 AWA 和 AWT 在基线（p>0.36）和随访（p>0.2）时均无显著差异。两组的 CRP 均显著降低（p<0.01），ACS 患者的降低幅度更大（p<0.01）。
ACS 患者的主动脉壁大小、主动脉壁面积和主动脉壁厚度均降低，而非 ACS 患者无变化。这些测量值在两组之间没有间隔差异。我们观察到两组的 CRP 均降低，ACS 患者的降低幅度更大。
