Kim Narae, Hwang Hui-Jeong, Yang In-Ho
Department of Cardiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea.
Biomedicines. 2024 Sep 23;12(9):2151. doi: 10.3390/biomedicines12092151.
: The role of treadmill stress echocardiography (TSE) in symptomatic patients may be limited. We evaluated whether carotid intima-media thickness (cIMT) and coronary artery calcium (CAC) scores can predict cardiovascular (CV) outcomes in patients with negative TSE. : Patients who had negative TSE and measured cIMT or CAC scoring were enrolled and followed up. The primary CV outcome was defined as a composite of acute coronary syndrome, coronary revascularization, heart failure, stroke, and CV death. : Overall, 1095 patients participated. The median follow-up duration was 5.8 years. Patients with increased cIMT and CAC scores experienced a high incidence of primary CV outcomes (normal vs. increased group on cIMT and CAC scoring: 4.4% vs. 20.0% and 0.4% vs. 25.0%, respectively, < 0.001). In the Cox proportional hazard model, increased cIMT and CAC scores were associated with increased primary CV outcomes (adjusted hazard ratio [95% confidence interval], -value for increased cIMT and increased CAC scores = 2.939 [1.241-6.960], = 0.014 and 45.192 [5.497-371.505], < 0.001, respectively). : Patients with increased cIMT and CAC scores have poor CV outcomes even though they have negative TSE results, and therefore, they should be carefully monitored.
跑步机负荷超声心动图（TSE）在有症状患者中的作用可能有限。我们评估了颈动脉内膜中层厚度（cIMT）和冠状动脉钙化（CAC）评分是否能预测TSE结果为阴性的患者的心血管（CV）结局。：纳入并随访了TSE结果为阴性且测量了cIMT或CAC评分的患者。主要CV结局定义为急性冠状动脉综合征、冠状动脉血运重建、心力衰竭、中风和CV死亡的综合结果。：总体而言，1095名患者参与。中位随访时间为5.8年。cIMT和CAC评分升高的患者发生主要CV结局的发生率较高（cIMT和CAC评分正常组与升高组分别为4.4%对20.0%和0.4%对25.0%，<0.001）。在Cox比例风险模型中，cIMT和CAC评分升高与主要CV结局增加相关（调整后的风险比[95%置信区间]，cIMT升高和CAC评分升高的P值分别为2.939[1.241 - 6.960]，P = 0.014和45.192[5.497 - 371.505]，P < 0.001）。：cIMT和CAC评分升高的患者即使TSE结果为阴性，其CV结局也较差，因此，应仔细监测他们。
