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颈动脉钙化作为全身血管事件的预测指标。

Carotid artery calcification as a predictor of systemic vascular events.

作者信息

Sano Noritaka, Kobayashi Tamaki, Kataoka Hiroharu, Ishigami Akiko, Shimahara Yusuke, Morita Naomi, Yamada Masanobu, Nishimura Kunihiro, Iihara Koji

机构信息

Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan.

Department of Neurosurgery, Kyoto University Hospital, Kyoto, Japan.

出版信息

Vasc Med. 2025 Aug;30(4):414-422. doi: 10.1177/1358863X251325808. Epub 2025 May 9.

Abstract

BACKGROUND

Coronary calcification is a well-known predictor of coronary events, yet the impact of carotid artery calcification on systemic vascular events (e.g., cerebral ischemic, coronary, and peripheral artery events) remains unclear. The aim of this study was to determine whether carotid calcification can be used to predict systemic vascular events.

METHODS

This single-center, retrospective cohort study included 194 patients who had a history of vascular disease, including carotid stenosis or occlusion, coronary artery disease, valvular heart disease, ischemic stroke, or transient ischemic attack. We collected data pertaining to risk factors and laboratory parameters. Calcification of the carotid arteries was assessed via whole-body computed tomography, and the modified carotid Agatston calcium score (CCS) was determined. Participants were divided into two CCS groups according to the cut-off value determined via receiver operating characteristic curve analysis; high CCS ≥ 126 and low CCS < 126. Coronary, ischemic cerebrovascular, and peripheral vascular events were recorded over a 5-year follow-up period, and their incidence was compared between the groups using Cox proportional hazards regression analysis.

RESULTS

Older age, hypertension, and chronic kidney disease had a significant positive impact on the CCS. Systemic vascular events (hazard ratio [HR]: 2.70, CI: 1.07-6.79, = 0.022), coronary events (HR: 4.29, CI: 0.87-21.1, = 0.045), and peripheral vascular events ( = 0.032) were significantly more frequent in the high versus low CCS group.

CONCLUSION

The CCS may be a useful tool for predicting future systemic vascular events, including those related to coronary and peripheral artery diseases.

摘要

背景

冠状动脉钙化是冠状动脉事件的一个众所周知的预测指标,然而颈动脉钙化对全身血管事件(如脑缺血、冠状动脉和外周动脉事件)的影响仍不清楚。本研究的目的是确定颈动脉钙化是否可用于预测全身血管事件。

方法

这项单中心回顾性队列研究纳入了194例有血管疾病病史的患者,包括颈动脉狭窄或闭塞、冠状动脉疾病、心脏瓣膜病、缺血性中风或短暂性脑缺血发作。我们收集了有关危险因素和实验室参数的数据。通过全身计算机断层扫描评估颈动脉钙化情况,并确定改良的颈动脉阿加斯顿钙评分(CCS)。根据通过受试者工作特征曲线分析确定的临界值,将参与者分为两个CCS组;高CCS≥126和低CCS<126。在5年的随访期内记录冠状动脉、缺血性脑血管和外周血管事件,并使用Cox比例风险回归分析比较两组之间的发生率。

结果

年龄较大、高血压和慢性肾脏病对CCS有显著的正向影响。高CCS组的全身血管事件(风险比[HR]:2.70,CI:1.07 - 6.79,P = 0.022)、冠状动脉事件(HR:4.29,CI:0.87 - 21.1,P = 0.045)和外周血管事件(P = 0.032)明显比低CCS组更频繁。

结论

CCS可能是预测未来全身血管事件的有用工具,包括与冠状动脉和外周动脉疾病相关的事件。

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