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颈动脉内膜中层厚度与非ST段抬高型心肌梗死患者的长期死亡率相关。

Carotid Intima-Media Thickness Is Associated with Long-Term Mortality in Patients with Non-ST Segment Elevation Myocardial Infarction.

作者信息

Koc Ayse Selcan, Cetin Abdullah Eren, Icen Yahya Kemal, Sumbul Hilmi Erdem, Ugurlu Mehmet, Izlimek Ugur Can, Koc Mevlut

机构信息

Department of Radiology, University of Health Sciences-Adana Health Practice and Research Center, Adana 01230, Turkey.

Department of Cardiology, 25 Aralık State Hospital, Gaziantep 27060, Turkey.

出版信息

J Clin Med. 2025 Jun 23;14(13):4461. doi: 10.3390/jcm14134461.

Abstract

: There is insufficient data in the literature on the relationship between carotid intima-media thickness (cIMT) measured in non-ST segment elevation myocardial infarction (NSTEMI) and cardiovascular (CV) mortality. Therefore, we aimed to determine the effect of cIMT value on long-term mortality in patients with NSTEMI. This retrospective cohort study included 279 patients with NSTEMI. In addition to clinical, demographic, laboratory, and angiographic investigations, cIMT, femoral IMT (fIMT), and aortic IMT (aIMT) were measured by B-mode ultrasonography. All patients received follow-up evaluation for CV mortality. The patients were grouped as with and without mortality. : Patients with NSTEMI received follow-up evaluations for 7.51 ± 0.85 years and 77 (27.6%) patients had mortality. Age, creatinine, blood urea nitrogen, cIMT, aIMT, fIMT, and SYNTAX score values were significantly higher in patients with mortality compared to patients without mortality. Hemoglobin, total cholesterol, LDL cholesterol, triglyceride levels, and left ventricular ejection fraction were significantly lower in patients with mortality compared to patients without mortality. In multivariate analysis, cIMT, age, and creatinine level were found to be independent predictors of mortality. Among these parameters, an increase in age (each year), carotid IMT (each 0.1 mm), and serum creatinine (each 0.1 mg/L) levels predicted an increase in mortality by 8%, 46.5%, and 12.6%, respectively. In ROC analysis, age, cIMT, and creatinine level were found to determine the development of mortality due to NSTEMI with acceptable sensitivity and specificity when an age of 65 years, 0.80 mm, and 0.90 mg/L were taken as cut-off values, respectively. : In patients with NSTEMI, cIMT measurement is independently associated with the development of long-term mortality.

摘要

关于非ST段抬高型心肌梗死(NSTEMI)患者中测量的颈动脉内膜中层厚度(cIMT)与心血管(CV)死亡率之间的关系,文献中的数据不足。因此,我们旨在确定cIMT值对NSTEMI患者长期死亡率的影响。这项回顾性队列研究纳入了279例NSTEMI患者。除了进行临床、人口统计学、实验室和血管造影检查外,还通过B型超声测量了cIMT、股动脉内膜中层厚度(fIMT)和主动脉内膜中层厚度(aIMT)。所有患者均接受了心血管死亡率的随访评估。将患者分为有死亡和无死亡两组。NSTEMI患者的随访时间为7.51±0.85年,77例(27.6%)患者死亡。与无死亡患者相比,死亡患者的年龄、肌酐、血尿素氮、cIMT、aIMT、fIMT和SYNTAX评分值显著更高。与无死亡患者相比,死亡患者的血红蛋白、总胆固醇、低密度脂蛋白胆固醇、甘油三酯水平和左心室射血分数显著更低。在多变量分析中,发现cIMT、年龄和肌酐水平是死亡率的独立预测因素。在这些参数中,年龄每增加1岁、颈动脉内膜中层厚度每增加0.1mm、血清肌酐每增加0.1mg/L,死亡率分别增加8%、46.5%和12.6%。在ROC分析中,当分别将65岁、0.80mm和0.90mg/L作为临界值时,发现年龄、cIMT和肌酐水平能够以可接受的敏感性和特异性确定NSTEMI导致的死亡发生情况。在NSTEMI患者中,cIMT测量与长期死亡率的发生独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f8c/12249878/8434dd31c89b/jcm-14-04461-g001.jpg

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