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比较弗明汉风险评分和动脉粥样硬化指数在左前降支心肌桥患者中的预测价值。

Comparison of Framingham risk score and atherogenic indices as a predictor of atherosclerosis in patients with myocardial bridge in left anterior descending artery.

机构信息

Department of Cardiology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey.

Department of Cardiology, Training and Research Hospital, Mugla Sitki Kocman University, Mugla, Turkey.

出版信息

Acta Cardiol. 2022 Jun;77(4):342-349. doi: 10.1080/00015385.2021.1945763. Epub 2021 Jul 2.

DOI:10.1080/00015385.2021.1945763
PMID:34210253
Abstract

BACKGROUND

Myocardial bridge (MB) is generally considered as a benign condition, but it may trigger atherosclerosis, especially in the adjacent proximal coronary artery segment. In this study, we aimed to investigate whether the Framingham risk score (FRS) or atherogenic indices are risk factors for coronary atherosclerosis in patients with MB in the left anterior descending coronary artery (LAD).

METHODS

We performed a retrospective study evaluating 155 patients who have MB in LAD. The patients were evaluated in two groups according to the presence of atherosclerosis (74 patients in atherosclerotic group 81 patients in non-atherosclerotic group). Baseline characteristics, FRS and atherogenic indices were reviewed between groups. Significant independent risk factors for coronary atherosclerosis were investigated by logistic regression analysis.

RESULTS

Patients in atherosclerotic group were significantly older (58.15 ± 10.04  50.22 ± 9.27 years,  < .001) and 74.3% of the patients were male. While the mean FRS in the atherosclerotic group was 21.20 ± 8.81, it was 12.79 ± 8.61 in the non-atherosclerotic group ( < .001). Among the atherogenic indices, only LDL-c/HDL-c ratio was significantly higher in the atherosclerotic group (3.49 ± 1.2 vs. 3.11 ± 0.98, :.033). Multivariable analysis showed that age (OR: 1.08, 95% CI 1.03-1.13,  < .001) and FRS (OR: 1.06, 95% CI 1.01-1.11, :.012) were independently associated with the presence of atherosclerotic lesion.

CONCLUSIONS

FRS is an easily applicable predictor in clinical practice that indicates the presence of coronary atherosclerosis in patients with MB in LAD.

摘要

背景

心肌桥(MB)通常被认为是良性的,但它可能引发动脉粥样硬化,特别是在相邻的近端冠状动脉节段。在这项研究中,我们旨在探讨 Framingham 风险评分(FRS)或致动脉粥样硬化指数是否是左前降支(LAD)MB 患者发生冠状动脉粥样硬化的危险因素。

方法

我们进行了一项回顾性研究,评估了 155 例 LAD 有 MB 的患者。根据是否存在动脉粥样硬化(粥样硬化组 74 例,非粥样硬化组 81 例)将患者分为两组。比较两组间的基线特征、FRS 和致动脉粥样硬化指数。通过 logistic 回归分析探讨冠状动脉粥样硬化的显著独立危险因素。

结果

粥样硬化组患者年龄明显较大(58.15 ± 10.04 岁比 50.22 ± 9.27 岁, < .001),且 74.3%的患者为男性。而在粥样硬化组,FRS 的平均值为 21.20 ± 8.81,而非粥样硬化组为 12.79 ± 8.61( < .001)。在致动脉粥样硬化指数中,只有 LDL-c/HDL-c 比值在粥样硬化组中明显较高(3.49 ± 1.2 比 3.11 ± 0.98, :.033)。多变量分析显示,年龄(OR:1.08,95%CI 1.03-1.13,  < .001)和 FRS(OR:1.06,95%CI 1.01-1.11, :.012)与粥样硬化病变的存在独立相关。

结论

FRS 是一种在临床实践中易于应用的预测指标,可提示 LAD 中 MB 患者存在冠状动脉粥样硬化。

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