接受冠状动脉计算机断层扫描血管造影的高血压患者主要不良心血管事件与Gensini评分或冠状动脉钙化评分之间的关联
Association Between Major Adverse Cardiovascular Events and the Gensini Score or Coronary Artery Calcification Score in Hypertensive Patients Who Have Undergone Coronary Computed Tomography Angiography.
作者信息
Shiga Yuhei, Tashiro Kohei, Miura Erica, Higashi Sara, Kawahira Yuto, Kuwano Takashi, Sugihara Makoto, Miura Shin-Ichiro
机构信息
Department of Cardiology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Houmonsinryo Medical Heart Clinic Fukuoka, Fukuoka, Japan.
出版信息
Cardiol Res. 2023 Apr;14(2):91-96. doi: 10.14740/cr1453. Epub 2023 Mar 25.
BACKGROUND
From the Fukuoka University Coronary Computed Tomography Angiography (FU-CCTA) registry, we present major adverse cardiovascular events (MACEs) in hypertensive patients who have undergone CCTA, and the association between MACEs and the Gensini score of coronary arteries or the coronary artery calcification (CAC) score.
METHODS
Of the patients who underwent CCTA for coronary artery disease (CAD) screening at Fukuoka University Hospital, 318 hypertensive patients who had at least one cardiovascular risk factor or suspected CAD were enrolled. The patients were divided into two groups: MACEs and non-MACEs groups. The severity of atherosclerosis of coronary arteries was assessed by the Gensini score. The CAC score was also defined by computed tomography (CT) images at the time of CCTA. A primary endpoint was MACEs (all-cause death, ischemic stroke, acute myocardial infarction, coronary revascularization). The patients were followed for up to 5 years.
RESULTS
The patients were 68 ± 10 years, and 50% were males. The percentages of smoking, dyslipidemia, diabetes, and chronic kidney disease were 39%, 70%, 26% and 37%, respectively. The %males, %smoking, CAC score and Gensini score in the MACEs group were significantly higher than those in the non-MACEs group. On the other hand, the differences in age, dyslipidemia, diabetes, or chronic kidney disease between the groups were not seen. A multivariate analysis was performed regarding the presence or absence of MACE by logistic regression analysis of the CAC score or Gensini score in addition to conventional risk factors as independent variables. A Cox regression analysis revealed significant relationships for both the CAC score (P = 0.043) and the Gensini score (P = 0.008).
CONCLUSIONS
The CAC score and the Gensini score could predict MACEs in hypertensive patients who have undergone CCTA.
背景
我们从福冈大学冠状动脉计算机断层扫描血管造影（FU-CCTA）登记处，呈现了接受CCTA检查的高血压患者的主要不良心血管事件（MACE），以及MACE与冠状动脉Gensini评分或冠状动脉钙化（CAC）评分之间的关联。
方法
在福冈大学医院因冠状动脉疾病（CAD）筛查而接受CCTA检查的患者中，纳入了318例至少有一个心血管危险因素或疑似CAD的高血压患者。患者被分为两组：MACE组和非MACE组。通过Gensini评分评估冠状动脉粥样硬化的严重程度。CAC评分也由CCTA时的计算机断层扫描（CT）图像确定。主要终点是MACE（全因死亡、缺血性中风、急性心肌梗死、冠状动脉血运重建）。对患者进行了长达5年的随访。
结果
患者年龄为68±10岁，50%为男性。吸烟、血脂异常、糖尿病和慢性肾脏病的比例分别为39%、70%、26%和37%。MACE组的男性比例、吸烟比例、CAC评分和Gensini评分显著高于非MACE组。另一方面，两组之间在年龄、血脂异常、糖尿病或慢性肾脏病方面未见差异。除了将传统危险因素作为自变量外，还通过对CAC评分或Gensini评分进行逻辑回归分析，对MACE的存在与否进行了多变量分析。Cox回归分析显示，CAC评分（P = 0.043）和Gensini评分（P = 0.008）均存在显著相关性。
结论
CAC评分和Gensini评分可以预测接受CCTA检查的高血压患者的MACE。
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