Zhu Yuhui, Wu Jufang, Wei Di, Huang Guangdi, Jiang Yundan, Feng Xiaorong
Radiology Department of The Second Affiliated Hospital, School of Medicine, The Chinese University of Hong Kong, Shenzhen & Longgang District People's Hospital of Shenzhen, Shenzhen, China.
Department of Radiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Quant Imaging Med Surg. 2024 Dec 5;14(12):8227-8237. doi: 10.21037/qims-24-579. Epub 2024 Nov 8.
Coronary heart disease (CHD) remains a leading cause of morbidity and mortality worldwide. Early detection and risk stratification are crucial for effective management. This study evaluates the efficacy of coronary computed tomography angiography (CTA) in CHD screening and analyses its correlation with traditional risk factors in an asymptomatic population.
This study focused on 1,000 patients aged 40-80 years who visited two comprehensive tertiary hospitals in the region between January 2020 and December 2022. Patients with a history of coronary revascularisation, arrhythmia or poor image quality were excluded. CTA was used to assess the coronary artery calcium score (CACS), stenosis severity, plaque characteristics and myocardial perfusion and function. These parameters were analysed alongside traditional risk factors (e.g., age, sex, body mass index, blood pressure, glucose and lipid levels, smoking status and family history) using logistic regression to determine their correlation with CHD.
This study found a significant correlation between the CACS and CHD severity. CTA results showed that 41.2% of patients had normal results, 28.8% had mild CHD, 20.0% had moderate CHD and 10.0% had severe CHD. Traditional risk factors were independently associated with CHD. Myocardial perfusion and function parameters also correlated significantly with CTA findings, declining progressively with increasing CHD severity.
CTA provides a comprehensive assessment of CHD, correlating significantly with traditional risk factors and myocardial functional parameters. Its use in screening could facilitate the early detection and tailored management of CHD in asymptomatic individuals. Further research is warranted to establish its predictive value for long-term cardiovascular outcomes.
冠心病（CHD）仍是全球发病和死亡的主要原因。早期检测和风险分层对于有效管理至关重要。本研究评估冠状动脉计算机断层扫描血管造影（CTA）在冠心病筛查中的疗效，并分析其与无症状人群中传统危险因素的相关性。
本研究聚焦于2020年1月至2022年12月期间在该地区两家综合性三级医院就诊的1000例40 - 80岁患者。排除有冠状动脉血运重建史、心律失常或图像质量差的患者。使用CTA评估冠状动脉钙化积分（CACS）、狭窄严重程度、斑块特征以及心肌灌注和功能。使用逻辑回归分析这些参数以及传统危险因素（如年龄、性别、体重指数、血压、血糖和血脂水平、吸烟状况和家族史），以确定它们与冠心病的相关性。
本研究发现CACS与冠心病严重程度之间存在显著相关性。CTA结果显示，41.2%的患者结果正常，28.8%患有轻度冠心病，20.0%患有中度冠心病，10.0%患有重度冠心病。传统危险因素与冠心病独立相关。心肌灌注和功能参数也与CTA结果显著相关，并随着冠心病严重程度的增加而逐渐下降。
CTA提供了对冠心病的全面评估，与传统危险因素和心肌功能参数显著相关。其在筛查中的应用有助于无症状个体中冠心病的早期检测和个性化管理。有必要进行进一步研究以确定其对长期心血管结局的预测价值。
