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冠状动脉异常起源:行冠状动脉计算机断层成像血管造影术成年人的患病率和冠状动脉疾病。

Anomalous origin of the coronary artery: prevalence and coronary artery disease in adults undergoing coronary tomographic angiography.

机构信息

Department of Cardiology, Xinqiao Hospital, Army Medical University, Shapingba District, Chongqing, China.

Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

BMC Cardiovasc Disord. 2024 May 23;24(1):271. doi: 10.1186/s12872-024-03942-8.

Abstract

BACKGROUND

Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital coronary anomaly with the potential to cause adverse cardiac events. However, there is limited data on the association between AAOCA and coronary artery disease (CAD). Therefore, the aim of this study is to determine the prevalence and symptoms of patients with AAOCA, as well as investigate the correlation between AAOCA and CAD in a population referred for coronary computed tomographic angiography (CTA).

METHODS AND RESULTS

All consecutive patients who underwent CTA from 2010 to 2021 were included. Characteristics, symptoms, coronary related adverse events and CTA information were reviewed by medical records. Separate multivariable cumulative logistic regressions were performed, using the stenosis severity in each of the four coronaries as individual responses and as a combined patient clustered response. Finally, we identified 207 adult patients with AAOCA, the prevalence of AAOCA is 0.23% (207/90,501). Moreover, this study found no significant association between AAOCA and CAD. AAOCA did not contribute to higher rates of hospitalization or adverse cardiac events, including calcification.

CONCLUSION

AAOCA is a rare congenital disease that is not associated with increased presence of obstructive CAD in adults.

摘要

背景

冠状动脉异常起源(AAOCA)是一种罕见的先天性冠状动脉异常,有可能导致不良心脏事件。然而,关于 AAOCA 与冠状动脉疾病(CAD)之间的关联,数据有限。因此,本研究旨在确定接受冠状动脉计算机断层扫描血管造影(CTA)检查的人群中 AAOCA 患者的患病率和症状,并探讨 AAOCA 与 CAD 之间的相关性。

方法和结果

纳入了 2010 年至 2021 年期间进行 CTA 的所有连续患者。通过病历回顾了特征、症状、与冠状动脉相关的不良事件和 CTA 信息。分别使用每支冠状动脉狭窄程度作为个体反应和患者聚类反应的组合,进行了多变量累积逻辑回归。最终,我们确定了 207 例成人 AAOCA 患者,AAOCA 的患病率为 0.23%(207/90,501)。此外,本研究未发现 AAOCA 与 CAD 之间存在显著相关性。AAOCA 并未导致更高的住院率或不良心脏事件,包括钙化。

结论

AAOCA 是一种罕见的先天性疾病,在成年人中与阻塞性 CAD 的发生率增加无关。

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