Refaat Hesham, Tantawy Ayman
Cardiology Department, Zagazig University, 44519 Zagazig, Egypt.
Rev Cardiovasc Med. 2024 May 9;25(5):160. doi: 10.31083/j.rcm2505160. eCollection 2024 May.
The most common cause of coronary artery diseases (CAD) is atherosclerosis. The synergy between percutaneous coronary intervention with TAXUS™ and cardiac surgery (SYNTAX) score was used to assess complex CAD lesions. The renal resistive index (RRI) is a Doppler ultrasound parameter calculated to assess renal haemodynamics. The direct relationship between CAD complexity and RRI was not yet investigated. The aim of our study was to investigate this relationship between RRI and SYNTAX score in stable CAD patients.
This study included 214 patients with stable CAD and subsequent coronary angiography done at our institution. Regarding CAD complexity, these patients were classified into 166 patients with low SYNTAX score (SYNTAX 22), and 48 patients with high SYNTAX score (SYNTAX 22). The demographic, laboratory, clinical, echocardiographic data and renal Doppler parameters; including RRI, were recorded.
Multivariate logistic regression analysis demonstrated that RRI (odds ratio, OR = 4.440, 95% (confidence interval) CI: 1.418-13.903, = 0.010) was a novel independent predictor of high SYNTAX score in patients with stable CAD, in addition to other traditional predictors as diabetes mellitus (OR = 4.401, 95% CI: 1.081-17.923, = 0.04), low-density lipoprotein cholesterol (LDL-C) (OR = 2.957, 95% CI: 1.920-8.995, = 0.027), multi-vessel CAD (OR = 2.113, 95% CI: 1.241-2.280, = 0.001) and Gensini score (OR = 6.539, 95% CI: 1.977-21.626, = 0.002). Receiver operator characteristic curve analysis showed that RRI 0.655 (sensitivity of 80%, specificity of 73.6%) was the best cut-off value for predicting high SYNTAX score.
The non-invasively measured RRI is closely associated with high SYNTAX score in stable CAD patients.
冠状动脉疾病（CAD）最常见的病因是动脉粥样硬化。TAXUS™药物涂层支架经皮冠状动脉介入治疗与心脏手术（SYNTAX）评分之间的协同作用被用于评估复杂CAD病变。肾阻力指数（RRI）是通过多普勒超声计算得出的评估肾血流动力学的参数。CAD复杂性与RRI之间的直接关系尚未得到研究。我们研究的目的是调查稳定型CAD患者中RRI与SYNTAX评分之间的这种关系。
本研究纳入了214例在我院接受后续冠状动脉造影的稳定型CAD患者。根据CAD的复杂性，这些患者被分为166例低SYNTAX评分（SYNTAX＜22）患者和48例高SYNTAX评分（SYNTAX≥22）患者。记录了人口统计学、实验室、临床、超声心动图数据以及包括RRI在内的肾多普勒参数。
多因素逻辑回归分析表明，RRI（比值比，OR = 4.440，95%（置信区间）CI：1.418 - 13.903，P = 0.010）是稳定型CAD患者高SYNTAX评分的一个新的独立预测因子，此外还有其他传统预测因子，如糖尿病（OR = 4.401，95% CI：1.081 - 17.923，P = 0.04）、低密度脂蛋白胆固醇（LDL-C）（OR = 2.957，95% CI：1.920 - 8.995，P = 0.027）、多支血管CAD（OR = 2.113，95% CI：1.241 - 2.280，P = 0.001）和Gensini评分（OR = 6.539，95% CI：1.977 - 21.626，P = 0.002）。受试者工作特征曲线分析显示，RRI≥0.655（灵敏度为80%，特异度为73.6%）是预测高SYNTAX评分的最佳截断值。
在稳定型CAD患者中，非侵入性测量的RRI与高SYNTAX评分密切相关。
