Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey.
Department of Radiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey.
Angiology. 2021 Sep;72(8):754-761. doi: 10.1177/0003319721998853. Epub 2021 Mar 5.
Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; < .001) were independent predictors of intermediate or high SS. An AAIMT <1.3 mm had a negative predictive value of 98% for the presence of intermediate or high SS and 83% for obstructive CAD. In conclusion, AAIMT showed a significant and independent predictive value for intermediate or high SS. Therefore, AAIMT may be a noninvasive and useful tool for decision-making by cardiologists (eg, to use a more invasive approach).
准确识别冠状动脉疾病（CAD）是指导疑似心绞痛患者检查的关键要素。动脉壁增厚是动脉粥样硬化的标志。因此，本研究的主要目的是确定腹主动脉内膜中层厚度（AAIMT），这是动脉粥样硬化表现的最早区域，是否对 CAD 严重程度具有预测价值。
共有 255 例连续患者因疑似稳定型心绞痛而被转介进行有创冠状动脉造影，前瞻性纳入本研究。在冠状动脉造影前，采用 B 型超声检查确定 AAIMT。用 SYNTAX 评分（SS）评估冠状动脉疾病严重程度。高血压病史、年龄、血脂异常和较高的 AAIMT（比值比：2.570；95%置信区间 1.831-3.608； <.001）是中间或高 SS 的独立预测因子。AAIMT <1.3 毫米对中间或高 SS 的存在具有 98%的阴性预测值，对阻塞性 CAD 的预测值为 83%。
总之，AAIMT 对中间或高 SS 具有显著的独立预测价值。因此，AAIMT 可能是一种非侵入性且有用的工具，可供心脏病专家做出决策（例如，采用更具侵入性的方法）。
