Department of Cardiology, The Second Hospital of Shandong University, Shandong, China; Shenzhen Research Institute of Shandong University, Guangdong, China.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Atherosclerosis. 2024 Jul;394:117242. doi: 10.1016/j.atherosclerosis.2023.117242. Epub 2023 Aug 18.
We aimed to investigate whether neck circumference (NC) can predict metabolic syndrome (MetS), coronary calcification and lesion, and major adverse cardiovascular events (MACEs).
A total of 867 patients with acute coronary syndrome (ACS) over 60 years old from the Second Hospital of Shandong University, who had undergone coronary computed tomography, were randomly selected for a retrospective analysis. The subjects were divided into male and female groups, NC quartile 1-4 groups (Q1-Q4 groups), non-multivessel coronary disease (non-MVCD) and multi-vessel coronary disease (MVCD) groups.
After adjusting for potential confounders, NC was associated with risk factors promoting coronary artery disease (CAD) and coronary artery calcification score (CACS). The severity of CAD increased by 0.202 times and 0.372 times for each unit of NC in male and female groups, respectively. Compared with the lower CACS group, the risk of coronary calcification increased by 0.139 times, and MVCD increased 0.268 times, with each unit increase of NC. Except for all-cause death, there were significant differences between the Q1-Q4 groups in the prevalence of all primary endpoints, cardiogenic death, unexpected re-hospitalization of heart failure, ACS recurrence or unplanned revascularization, and non-fatal stroke (p log-rank <0.01). In view of the overall trend, with the increase of NC quartiles, the prevalence of MACEs gradually increased (all p < 0.01).
NC is closely associated with MetS and its components, coronary calcification and lesion degree, and MACEs. NC could be used as surrogate of CACS to predict the coronary condition and prognosis of elderly patients with ACS.
本研究旨在探讨颈围（NC）能否预测代谢综合征（MetS）、冠状动脉钙化和病变以及主要不良心血管事件（MACEs）。
本研究回顾性分析了来自山东大学第二医院的 867 名年龄超过 60 岁的急性冠状动脉综合征（ACS）患者的冠状动脉计算机断层扫描资料。将患者分为男性和女性组、NC 四分位 1-4 组（Q1-Q4 组）、非多血管性冠状动脉疾病（non-MVCD）和多血管性冠状动脉疾病（MVCD）组。
校正潜在混杂因素后，NC 与促进冠状动脉疾病（CAD）和冠状动脉钙化评分（CACS）的危险因素相关。在男性和女性组中，NC 每增加一个单位，CAD 的严重程度分别增加 0.202 倍和 0.372 倍。与较低的 CACS 组相比，NC 每增加一个单位，冠状动脉钙化的风险增加 0.139 倍，MVCD 增加 0.268 倍。除全因死亡外，Q1-Q4 组之间所有主要终点事件、心源性死亡、心力衰竭意外再住院、ACS 复发或计划外血运重建以及非致死性卒中的发生率差异均有统计学意义（p log-rank<0.01）。从整体趋势来看，随着 NC 四分位的升高，MACEs 的发生率逐渐升高（均 p<0.01）。
NC 与 MetS 及其成分、冠状动脉钙化和病变程度以及 MACEs 密切相关。NC 可作为 CACS 的替代指标，用于预测老年 ACS 患者的冠状动脉状况和预后。
