Wang Qin, Li Jingchun, Cheng Jing
Department of Ultrasound, Funan County Hospital of Traditional Chinese Medicine, Fuyang, Anhui, China.
Br J Hosp Med (Lond). 2025 Feb 25;86(2):1-17. doi: 10.12968/hmed.2024.0682.
Coronary angiography is a widely used invasive approach for diagnosing coronary atherosclerotic heart disease (CHD). However, carotid ultrasound may predict CHD by assessing carotid atherosclerosis. Therefore, this study explores the predictive significance of carotid ultrasound parameters in accurately diagnosing coronary artery disease. This retrospective analysis included 82 CHD patients who underwent carotid ultrasound scans at the Funan County Hospital of Traditional Chinese Medicine, China, between July 2021 and February 2024. Based on coronary angiography results, patients were divided into the CHD (n = 48) and non-CHD (n = 34) groups. Differences in clinical data, biochemical indicators, and carotid ultrasound parameters were evaluated between the two experimental groups. Furthermore, correlation analysis assessed the association between ultrasound parameters and CHD occurrence and severity. Additionally, multivariable logistic regression analyses were performed, followed by developing a CHD prediction nomogram model. Finally, the model's performance was evaluated through analyses of receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves. The CHD group had higher body mass index (BMI), smoking history, diabetes, total cholesterol (TC), and triglycerides (TG) levels ( < 0.05). Furthermore, significantly higher intima-media thickness (IMT) and plaque score and lower plaque echogenicity grey scale median (GSM) were observed in the CHD group ( < 0.05). Pearson correlation showed a positive correlation between Gensini score and IMT, plaque score, and a negative association with plaque echogenicity GSM ( < 0.05). Spearman correlation revealed positive correlations between BMI, smoking history, diabetes, TG, TC, IMT, plaque score, and CHD diagnosis, and a negative correlation with plaque echogenicity GSM ( < 0.05). IMT and plaque score were identified as CHD risk factors and plaque echogenicity GSM as a protective factor ( < 0.05). The model based on carotid ultrasound parameters demonstrated high predictive performance for CHD, with an area under the curve (AUC) of 0.866 (95% confidence interval [CI]: 0.779-0.953). DCA and calibration curves supported the model's accuracy. Carotid ultrasound parameters differ significantly between CHD and non-CHD patients. The developed model using these parameters effectively predicts CHD occurrence, providing a valuable diagnostic alternative for coronary angiography.
冠状动脉造影是诊断冠状动脉粥样硬化性心脏病（CHD）广泛使用的侵入性方法。然而，颈动脉超声可通过评估颈动脉粥样硬化来预测冠心病。因此，本研究探讨颈动脉超声参数在准确诊断冠状动脉疾病中的预测意义。这项回顾性分析纳入了2021年7月至2024年2月在中国阜南县中医医院接受颈动脉超声扫描的82例冠心病患者。根据冠状动脉造影结果，将患者分为冠心病组（n = 48）和非冠心病组（n = 34）。评估了两组之间临床数据、生化指标和颈动脉超声参数的差异。此外，相关性分析评估了超声参数与冠心病发生和严重程度之间的关联。另外，进行了多变量逻辑回归分析，随后建立了冠心病预测列线图模型。最后，通过分析受试者工作特征（ROC）曲线、决策曲线分析（DCA）和校准曲线来评估模型的性能。冠心病组的体重指数（BMI）、吸烟史、糖尿病、总胆固醇（TC）和甘油三酯（TG）水平较高（<0.05）。此外，冠心病组的内膜中层厚度（IMT）和斑块评分显著更高，斑块回声灰度中位数（GSM）更低（<0.05）。Pearson相关性显示，Gensini评分与IMT、斑块评分呈正相关，与斑块回声GSM呈负相关（<0.05）。Spearman相关性显示，BMI、吸烟史、糖尿病、TG、TC、IMT、斑块评分与冠心病诊断呈正相关，与斑块回声GSM呈负相关（<0.05）。IMT和斑块评分被确定为冠心病危险因素，斑块回声GSM为保护因素（<0.05）。基于颈动脉超声参数的模型对冠心病具有较高的预测性能，曲线下面积（AUC）为0.866（95%置信区间[CI]：0.779 - 0.953）。DCA和校准曲线支持了模型的准确性。冠心病患者和非冠心病患者的颈动脉超声参数存在显著差异。使用这些参数建立的模型有效地预测了冠心病的发生，为冠状动脉造影提供了一种有价值的诊断替代方法。
