Pathakota Sudhakar Reddy, Durgaprasad Rajasekhar, Velam Vanajakshamma, Ay Lakshmi, Kasala Latheef
Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.
Department of Radiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.
J Cardiovasc Thorac Res. 2020;12(2):78-83. doi: 10.34172/jcvtr.2020.14. Epub 2020 May 4.
Coronary artery calcium score (CACS) and carotid artery intima-media thickness (CIMT) are the markers of atherosclerosis. An association between CACS and CIMT with presence of atherosclerotic coronary artery disease (CAD) is well established. However relationship between severity of CAD with CACS and CIMT is less clear. This study aimed to investigate the correlation between severity of CAD assessed by SYNTAX and Gensini scores with CACS and CIMT. This prospective study was conducted on 351 patients with CAD between June 2015 to December 2016. CACS was obtained using AGATSTON algorithm with 128 slice multidetector computer tomography (MDCT) before conventional coronary angiography (CCA). CIMT was measured by using Philips IE33 Echo machine. The severity of CAD was assessed by SYNTAX score (SS) and Gensini score on CCA. Correlation between severity of CAD with CACS and CIMT was analysed. Mean CACS was 241.5±463.7, and this was positively correlated with over all SS (r=0.417, <0.0001) and Gensini score (r=0.405, <0.0001). Mean CIMT was 0.80±0.18 mm and this was also significantly correlated with SS (r=0.450, <0.0001) and Gensini score (r=0.459,<0.0001). Multivariate analysis showed that CACS was independently associated with diabetes mellitus (β:0.11, =0.021), SS (β:0.251, =0.010) and mean CIMT (β:0.128, =0.028). Receiver-operating characteristic (ROC) curve analysis revealed a cut off CACS of >493 for SS≥33 (high-SS tertile). Our study confirmed a significant correlation between CACS and CIMT with the severity of CAD assessed by SS and Gensini scores. CACS and CIMT may be considered as important noninvasive diagnostic modalities in the assessment of the severity of CAD.
冠状动脉钙化积分（CACS）和颈动脉内膜中层厚度（CIMT）是动脉粥样硬化的标志物。CACS和CIMT与动脉粥样硬化性冠状动脉疾病（CAD）的存在之间的关联已得到充分证实。然而，CAD的严重程度与CACS和CIMT之间的关系尚不清楚。本研究旨在探讨通过SYNTAX评分和Gensini评分评估的CAD严重程度与CACS和CIMT之间的相关性。这项前瞻性研究于2015年6月至2016年12月对351例CAD患者进行。在常规冠状动脉造影（CCA）之前，使用128层多排螺旋计算机断层扫描（MDCT）的AGATSTON算法获得CACS。使用飞利浦IE33超声仪测量CIMT。通过CCA上的SYNTAX评分（SS）和Gensini评分评估CAD的严重程度。分析CAD严重程度与CACS和CIMT之间的相关性。平均CACS为241.5±463.7，这与总体SS（r = 0.417，<0.0001）和Gensini评分（r = 0.405，<0.0001）呈正相关。平均CIMT为0.80±0.18mm，这也与SS（r = 0.450，<0.0001）和Gensini评分（r = 0.459，<0.0001）显著相关。多变量分析显示，CACS与糖尿病独立相关（β：0.11，P = 0.021）、SS（β：0.251，P = 0.010）和平均CIMT（β：0.128，P = 0.028）。受试者操作特征（ROC）曲线分析显示，对于SS≥33（高SS三分位数），CACS的截断值>493。我们的研究证实了CACS和CIMT与通过SS和Gensini评分评估的CAD严重程度之间存在显著相关性。CACS和CIMT可被视为评估CAD严重程度的重要非侵入性诊断方法。
