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颈动脉斑块内新生血管形成与经皮冠状动脉介入治疗后血管再通风险相关

[Carotid intraplaque neovascularization is correlated with the risk of revascularization following percutaneous coronary intervention].

作者信息

Han Y, Fei X, Ren L, Wang J, Chen T, Guo J, Wang Q

机构信息

Department of Cardiology, Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China.

Medical School of Chinese PLA, Beijing 100853, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2022 Jun 20;42(6):892-898. doi: 10.12122/j.issn.1673-4254.2022.06.13.

Abstract

OBJECTIVE

To investigate the correlation of intraplaque neovascularization (IPN) detected by carotid contrast-enhanced ultrasound (CEUS) with revascularization in patients following percutaneous coronary intervention (PCI).

METHODS

This study was conducted among 105 patients who were followed up for more than 12 months after PCI. All the patients received CEUS examination for assessment of carotid plaque formation and IPN, which were compared between patients with revascularization (REV group, =27) and those without revascularization (N-REV group, =78). ROC curve was used to analyze the diagnostic efficacy of CEUS for predicting revascularization. Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with revascularization.

RESULTS

In the REV group, the IPN score was 0 in 1 (3.7%) patient, 1 in 8 (29.6%) patients, 2 in 15 (55.6%) patients and 3 in 3 (11.1%) patients. Significant differences were noted between REV and N-REV groups in plaque length (15.70±6.93 12.10±6.64, < 0.05), maximum plaque thickness (3.69±1.12 3.14±1.18, < 0.05) and IPN (1.74±0.71 0.87±0.63, < 0.001). IPN score was identified as an independent risk factor for revascularization in patients following PCI, and at the cutoff value of 1.5, its sensitivity, specificity, positive predictive value, and negative predictive value for predicting the occurrence of revascularization were 74%, 89%, 69%, and 91%, respectively, with an AUC of 0.848 (95% : 0.703-0.905, < 0.001).

CONCLUSION

CEUS allows noninvasive and semi-quantitative assessment of neovascularization in carotid artery plaques, and IPN detected by CEUS is correlated with the risk of revascularization in patients following PCI.

摘要

目的

探讨经皮冠状动脉介入治疗(PCI)术后患者颈动脉超声造影(CEUS)检测的斑块内新生血管形成(IPN)与血管重建的相关性。

方法

本研究对105例PCI术后随访超过12个月的患者进行。所有患者均接受CEUS检查以评估颈动脉斑块形成及IPN情况,并在血管重建患者(REV组,n = 27)和未进行血管重建患者(N-REV组,n = 78)之间进行比较。采用ROC曲线分析CEUS预测血管重建的诊断效能。进行单因素和多因素逻辑回归分析以确定与血管重建相关的危险因素。

结果

在REV组中,IPN评分为0分的患者有1例(3.7%),1分的患者有8例(29.6%),2分的患者有15例(55.6%),3分的患者有3例(11.1%)。REV组和N-REV组在斑块长度(15.70±6.93 vs 12.10±6.64,P < 0.05)、最大斑块厚度(3.69±1.12 vs 3.14±1.18,P < 0.05)和IPN(1.74±0.71 vs 0.87±0.63,P < 0.001)方面存在显著差异。IPN评分被确定为PCI术后患者血管重建的独立危险因素,在截断值为1.5时,其预测血管重建发生的敏感性、特异性、阳性预测值和阴性预测值分别为74%、89%、69%和91%,AUC为0.848(95%CI:0.703 - 0.905,P < 0.001)。

结论

CEUS可对颈动脉斑块内新生血管形成进行无创性半定量评估,CEUS检测的IPN与PCI术后患者血管重建风险相关。

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