Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053, China.
Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China.
BMC Cardiovasc Disord. 2024 Nov 26;24(1):678. doi: 10.1186/s12872-024-04361-5.
The present study aimed to analyze the correlation between carotid atherosclerotic plaque (CAP) and/or subclavian atherosclerotic plaque (SAP) and coronary atherosclerosis disease (CASD).
A total of 1343 patients hospitalized for chest pain or tightness due to coronary atherosclerotic disease and underwent initial coronary angiography (CAG) were evaluated by color Doppler flow imaging (CDFI) for CAP and SAP. The patients were divided into four groups: non-CAP & non-SAP, only-SAP, only-CAP, or CAP & SAP. Finally, 1,242 patients were included in this study.
The incidence of CASD and main coronary artery disease in the CAP & SAP group was higher than that in the CAP-only group. Moreover, the detection rate of three-vessel disease (3-VD) in the CAP & SAP group was significantly higher than that in the CAP group (p < 0.05). The incidence of main coronary artery branch lesions in patients with CAP & SAP was approximately 1.5 times higher than in those with only CAP. Male gender, hypertension, and diabetes were independent risk factors for main coronary artery branch lesions. If the patient had CAP & SAP lesions and more than three cardiovascular disease risk factors, coronary artery main artery disease incidence was about 81.7% CONCLUSION: Based on the CDFI screening and combined with cardiovascular disease risk factors, the combined evaluation of CAP and SAP showed higher CASD prediction values than the CAP group alone. Early detection of coronary atherosclerotic stenosis and timely clinical intervention is expected to reduce the incidence of ischemic heart disease events caused by coronary atherosclerotic stenosis.
本研究旨在分析颈动脉粥样硬化斑块（CAP）和/或锁骨下动脉粥样硬化斑块（SAP）与冠状动脉粥样硬化性疾病（CASD）之间的相关性。
对 1343 例因冠状动脉粥样硬化性疾病而住院胸痛或胸闷的患者进行彩色多普勒血流成像（CDFI）检查，评估 CAP 和 SAP。患者分为四组：非 CAP & 非 SAP、仅 SAP、仅 CAP 或 CAP & SAP。最终，1242 例患者纳入本研究。
CAP & SAP 组的 CASD 和主要冠状动脉疾病发生率高于 CAP 组。此外，CAP & SAP 组的三支病变（3-VD）检出率明显高于 CAP 组（p < 0.05）。CAP & SAP 患者主要冠状动脉分支病变的发生率约为 CAP 患者的 1.5 倍。男性、高血压和糖尿病是主要冠状动脉分支病变的独立危险因素。如果患者同时存在 CAP & SAP 病变和超过三个心血管疾病危险因素，冠状动脉主要动脉疾病的发生率约为 81.7%。
基于 CDFI 筛查并结合心血管疾病危险因素，CAP 和 SAP 的联合评估比单独 CAP 组具有更高的 CASD 预测价值。早期发现冠状动脉粥样硬化性狭窄并及时进行临床干预，有望降低因冠状动脉粥样硬化性狭窄引起的缺血性心脏病事件的发生率。
