Synetos Andreas, Bounas Pavlos, Karanasos Antonis, Latsios George, Drakopoulou Maria, Papanikolaou Aggelos, Olympios Christoforos, Trantalis George, Tsioufis Konstantinos, Toutouzas Konstantinos
First Department of Cardiology, Hippokration Hospital, University of Athens Greece.
General Hospital of Elefsina "Thriassio" Athens.
Am J Cardiovasc Dis. 2021 Jun 15;11(3):360-367. eCollection 2021.
Carotid artery temperature heterogeneity (ΔΤ) measured by microwave radiometry (MWR) has been associated with future cardiovascular events including acute coronary syndromes. The vulnerable plaques of the coronary arterial tree, that can be ideally depicted by intracoronary imaging such as optical coherence tomography (OCT) have anatomical characteristics such as the thin fibrous cap (TCFA), that make them vulnerable to rupture. The scope of the study was to assess the implication of the carotid artery temperature heterogeneity on the culprit coronary plaque morphology in patients presenting with acute myocardial infarction.
34 patients presented with an acute myocardial infarction were enrolled in the study. All patients underwent percutaneous coronary intervention (PCI) and OCT for the evaluation of the anatomical characteristics of the culprit lesion. After the completion of the PCI all patients underwent carotid ultrasound and MWR of both carotid arteries and thermal heterogeneity of the carotid arteries was assessed. Blood samples were collected for high sensitivity C-reactive protein (CRP) analysis.
Thirty four patients, 21 with STEMI (61.76%) and 13 (38.23%) with NSTEMI, were included in the study. Patients with ruptured plaques had significantly increased hsCRP compared to patients that did not have a ruptured plaque (14.41±4.02 vs 9.9±2.5, P<0.005). Thermal heterogeneity, was significantly increased in ruptured plaques compared to no ruptured ones (1.01±0.31 vs 0.51±0.14°C, P=0.001), and in plaques with TCFA compared to those without a TCFA (0.82±0.37 vs 0.60±0.05°C, P=0.001). Diabetes mellitus, ΔΤ and hsCRP, were entered in the multivariate analysis, from which DM (OR 4.12; 95% CI 0.77-22.07; P=0.07) and ΔΤ (OR for 0.1°C increase 1.43; 95% CI 1.03-1.98; P=0.03) remained in the final analysis, and only ΔΤ was independently associated with the presence of the TCFA. Regarding plaque rupture, STEMI, hsCRP, and ΔT were entered in the multivariate analysis from which hsCRP (OR 1.51; 95% CI 0.99-2.28; P=0.051) and ΔΤ (OR for 0.1°C increase 3.40; 95% CI 1.29-8.96; P=0.013) remained in the final analysis with the ΔT being the only variable.
通过微波辐射测量法（MWR）测得的颈动脉温度异质性（ΔΤ）与包括急性冠脉综合征在内的未来心血管事件相关。冠状动脉树中的易损斑块可通过冠状动脉内成像如光学相干断层扫描（OCT）得到理想描绘，这些斑块具有薄纤维帽（TCFA）等解剖学特征，使其易于破裂。本研究的目的是评估颈动脉温度异质性对急性心肌梗死患者罪犯冠状动脉斑块形态的影响。
34例急性心肌梗死患者纳入本研究。所有患者均接受经皮冠状动脉介入治疗（PCI）及OCT检查以评估罪犯病变的解剖学特征。PCI完成后，所有患者均接受双侧颈动脉超声及MWR检查，评估颈动脉的热异质性。采集血样进行高敏C反应蛋白（CRP）分析。
34例患者纳入研究，其中21例为ST段抬高型心肌梗死（STEMI，占61.76%），13例为非ST段抬高型心肌梗死（NSTEMI，占38.23%）。与未破裂斑块的患者相比，斑块破裂患者的hsCRP显著升高（14.41±4.02 vs 9.9±2.5，P<0.005）。与未破裂斑块相比，破裂斑块的热异质性显著增加（1.01±0.31 vs 0.51±0.14°C，P=0.001），与无TCFA的斑块相比，有TCFA的斑块热异质性增加（0.82±0.37 vs 0.60±0.05°C，P=0.001）。将糖尿病、ΔΤ和hsCRP纳入多因素分析，最终分析中糖尿病（OR 4.12；95%CI 0.77-22.07；P=0.07）和ΔΤ（每升高0.1°C的OR为1.43；95%CI 1.03-1.98；P=0.03）仍存在，且只有ΔΤ与TCFA的存在独立相关。关于斑块破裂，将STEMI、hsCRP和ΔT纳入多因素分析，最终分析中hsCRP（OR 1.51；95%CI 0.99-2.28；P=0.051）和ΔΤ（每升高0.1°C的OR为3.40；95%CI 1.29-8.96；P=0.013）仍存在，且ΔT是唯一变量。
