Kiani Reza, Pouraliakbar Hamidreza, Alemzadeh-Ansari Mohammad Javad, Khademi Ali, Peighambari Mohamad Mehdi, Mohebbi Bahram, Firouzi Ata, Zahedmehr Ali, Shakerian Farshad, Hosseini Zahra, Rashidinejad Alireza
Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Radiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Thorac Res. 2020;12(3):203-208. doi: 10.34172/jcvtr.2020.34. Epub 2020 Sep 3.
Cardiovascular diseases, including coronary artery disease (CAD), are among the most common causes of death in the elderly population. Recent studies have found that coronary artery calcium score (CACS) is a strong independent predictor of CAD. Here we aimed to investigate the association between CACS and demographic, clinical, laboratory, and CT angiographic findings inpatients with suspected CAD. From June 2008 to August 2018, we retrospectively reviewed 219 consecutive patients suspected with CAD who were referred for CT angiography in Rajaie Cardiovascular, Medical, and Research Center. Medical records were reviewed, and relevant demographic, clinical, laboratory and imaging were collected. A total of 219 patients with an average age of 62.64±12.39 were included. Twelve patients(5.5%) had normal coronary angiography, and 50.2% had mild CAD. An obstructive CAD was found in97 patients (44.3%). The median CACS was 76.4 (IQR, 13.0-289.1). The frequency of obstructive CAD was 28.1% in the CACS <100 group, and 67.0% in CACS >100 group ( < 0.001). On multiple logistic regression analysis, age (OR=1.04 [1.01-1.07], = 0.006), CACS (OR= 4.31 [2.33-7.98], < 0.001), and neutrophil to lymphocyte ratio (NLR) (OR = 0.82 [0.68-0.98], = 0.027) were independent predictors of obstructive CAD. We found a direct association between higher CACS and obstructive patterns in coronary CT angiography. Our findings indicate that the possibility of the presence of obstructive CAD was higher among symptomatic patients with older age, lower NLR, and CACS >100.
心血管疾病，包括冠状动脉疾病（CAD），是老年人群中最常见的死亡原因之一。最近的研究发现，冠状动脉钙化评分（CACS）是CAD的一个强有力的独立预测指标。在此，我们旨在研究疑似CAD患者的CACS与人口统计学、临床、实验室及CT血管造影结果之间的关联。2008年6月至2018年8月，我们回顾性分析了拉贾伊心血管医学与研究中心连续219例因疑似CAD接受CT血管造影检查的患者。查阅病历并收集相关的人口统计学、临床、实验室及影像学资料。共纳入219例平均年龄为62.64±12.39岁的患者。12例（5.5%）患者冠状动脉造影正常，50.2%患者患有轻度CAD。97例（44.3%）患者存在阻塞性CAD。CACS的中位数为76.4（四分位间距，13.0 - 289.1）。CACS＜100组中阻塞性CAD的发生率为28.1%，CACS＞100组中为67.0%（P＜0.001）。多因素logistic回归分析显示，年龄（OR = 1.04[1.01 - 1.07]，P = 0.006）、CACS（OR = 4.31[2.33 - 7.98]，P＜0.001）和中性粒细胞与淋巴细胞比值（NLR）（OR = 0.82[0.68 - 0.98]，P = 0.027）是阻塞性CAD的独立预测因素。我们发现冠状动脉CT血管造影中较高的CACS与阻塞性病变之间存在直接关联。我们的研究结果表明，年龄较大、NLR较低且CACS＞100的有症状患者中存在阻塞性CAD的可能性更高。
