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北印度人群冠状动脉大小——基于血管内超声的研究。

Coronary artery size in North Indian population - Intravascular ultrasound-based study.

作者信息

Reddy Sreenivas, Kumar Suraj, Kashyap Jeet Ram, Rao Raghavendra, Kadiyala Vikas, Reddy Hithesh, Kaur Naindeep, Ramalingam Vadivelu, Kaur Jaspreet

机构信息

Department of Cardiology, Government Medical College and Hospital, Sector 32, 160030, Chandigarh, India; Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Department of Cardiology, Government Medical College and Hospital, Sector 32, 160030, Chandigarh, India.

出版信息

Indian Heart J. 2019 Sep-Oct;71(5):412-417. doi: 10.1016/j.ihj.2019.10.005. Epub 2019 Nov 5.

Abstract

OBJECTIVE

The coronary artery dimensions have important diagnostic and therapeutic implications in management of coronary artery disease (CAD). There is paucity of data on the coronary artery size in the Indian population as measured by intravascular ultrasound (IVUS).

METHODS

A total of 303 patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) with intravascular ultrasound underwent analysis along with quantitative coronary angiography (QCA). Of the 492 proximal coronary segments; 221 relating to left main (LM), 164 to left anterior descending artery (LAD), 45 to left circumflex artery (LCX), and 62 to right coronary artery (RCA) were considered.

RESULTS

Patient's mean age was 53.37 ± 3.5 years; men 80%; hypertension 35% and diabetes 24.8%. On IVUS, mean minimal lumen diameter as compared to QCA in LM (4.60 mm versus 4.50 mm, p < 0.001), LAD (3.71 mm versus 3.45 mm, p < 0.001), LCX (3.55 mm versus 3.16 mm, p < 0.001) and RCA (3.85 mm versus 3.27 mm, p < 0.001) were significantly larger. Lumen and external elastic membrane (EEM) cross-sectional area (CSA) were larger in males as compared to females with statistical significance for lumen CSA in LM (p = 0.04); RCA (p = 0.02) and EEM CSA in LM (p = 0.03); RCA (p = 0.006) but no significance for adjusted body surface area (BSA). In multivariate models, BSA and age were independent predictors of LM and LAD diameters and areas, but age was an independent predictor indexed to BSA.

CONCLUSION

The coronary artery dimensions by IVUS are significantly larger than QCA. No gender difference in coronary artery size. Age was an independent predictor of coronary artery size in left main and LAD. The coronary artery size may not be a risk factor for acute coronary syndrome.

摘要

目的

冠状动脉尺寸在冠状动脉疾病(CAD)的管理中具有重要的诊断和治疗意义。关于通过血管内超声(IVUS)测量的印度人群冠状动脉大小的数据较少。

方法

共有303例接受经皮冠状动脉介入治疗(PCI)并进行血管内超声检查的急性冠状动脉综合征(ACS)患者,同时进行了定量冠状动脉造影(QCA)分析。在492个冠状动脉近端节段中,包括221个左主干(LM)节段、164个左前降支(LAD)节段、45个左旋支(LCX)节段和62个右冠状动脉(RCA)节段。

结果

患者的平均年龄为53.37±3.5岁;男性占80%;高血压患者占35%,糖尿病患者占24.8%。在IVUS检查中,与QCA相比,LM(4.60毫米对4.50毫米,p<0.001)、LAD(3.71毫米对3.45毫米,p<0.001)、LCX(3.55毫米对3.16毫米,p<0.001)和RCA(3.85毫米对3.27毫米,p<0.001)的平均最小管腔直径明显更大。男性的管腔和外弹力膜(EEM)横截面积(CSA)大于女性,LM管腔CSA(p=0.04)、RCA(p=0.02)以及LM的EEM CSA(p=0.03)、RCA(p=0.006)具有统计学意义,但调整体表面积(BSA)后无显著差异。在多变量模型中,BSA和年龄是LM和LAD直径及面积的独立预测因素,但年龄是以BSA为索引的独立预测因素。

结论

IVUS测量的冠状动脉尺寸明显大于QCA。冠状动脉大小不存在性别差异。年龄是左主干和LAD冠状动脉大小的独立预测因素。冠状动脉大小可能不是急性冠状动脉综合征的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a586/7013999/5083c87e8f28/gr1.jpg

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