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心脏手术患者胸主动脉钙化的预测因素。

Predictive factors of thoracic aortic calcification in patients candidate for cardiac surgery.

机构信息

Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Cardiothorac Surg. 2024 Mar 23;19(1):152. doi: 10.1186/s13019-024-02636-8.

Abstract

BACKGROUND

The presence of the severe thoracic aortic calcification (TAC) in cardiac surgery patients is associated with adverse post-operative outcome. However, the relationship between cardiovascular risk factors and aortic plaque burden remains unknown. The objective of this study was to determine the predictive factors of TAC in patients candidate for cardiac surgery.

METHODS

Patients who underwent thoracic CT scan prior to cardiac surgery between August 2020 to April 2021 were included. Of 556 patients, 209 (36.7%) had a thoracic aortic calcium score (TACS) ≥ 400 mm [3] and were compare with the remaining patients. Predictors of severe TAC were assessed through stepwise multivariable logistic regression analysis.

RESULTS

The patients with TACS ≥ 400 had a higher mean age (67.3 ± 7.1 vs. 55.7 ± 10.6; p < 0.001) with a higher frequency of diabetes mellitus (40.7% vs. 30.8%; p = 0.018), dyslipidemia (49.8% vs. 38.6%; p = 0.010), hypertension (60.8% vs. 44.7%; p < 0.001), opium addiction (18.2% vs. 11.2%; p = 0.023), peripheral vascular disease (PVD) (7.7% vs. 2.3%; p = 0.005) as compared with TACS < 400. The multiple determinants of TAC were PVD (OR = 2.86) followed by opium addiction, diabetes and age.

CONCLUSIONS

Thoracic CT scan prior to cardiac surgery for patients with older age, diabetes, opium addiction and PVD is recommended. Our study could serve as a foundation for future research endeavors aimed at establishing a risk score for TAC.

摘要

背景

心脏手术患者存在严重的胸主动脉钙化(TAC)与术后不良预后相关。然而,心血管危险因素与主动脉斑块负担之间的关系尚不清楚。本研究的目的是确定心脏手术患者 TAC 的预测因素。

方法

纳入 2020 年 8 月至 2021 年 4 月期间在心脏手术前行胸部 CT 扫描的患者。556 例患者中,209 例(36.7%)的胸主动脉钙评分(TACS)≥400[3],与其余患者进行比较。通过逐步多变量逻辑回归分析评估严重 TAC 的预测因素。

结果

TACS≥400 的患者平均年龄较大(67.3±7.1 岁比 55.7±10.6 岁;p<0.001),糖尿病(40.7%比 30.8%;p=0.018)、血脂异常(49.8%比 38.6%;p=0.010)、高血压(60.8%比 44.7%;p<0.001)、阿片类药物成瘾(18.2%比 11.2%;p=0.023)、外周血管疾病(PVD)(7.7%比 2.3%;p=0.005)的发生率较高。TACS<400 的多因素决定因素是 PVD(OR=2.86),其次是阿片类药物成瘾、糖尿病和年龄。

结论

建议对年龄较大、患有糖尿病、阿片类药物成瘾和 PVD 的心脏手术患者进行胸部 CT 扫描。我们的研究可以为未来研究 TAC 风险评分奠定基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4139/10960493/125e36313eca/13019_2024_2636_Fig1_HTML.jpg

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