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首页> 外文期刊>Indian Journal of Nuclear Medicine >Single-photon emission computed tomography myocardial ischemia detection in high-risk asymptomatic patients: correlation with coronary calcium score and high-sensitivity C-reactive protein
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Single-photon emission computed tomography myocardial ischemia detection in high-risk asymptomatic patients: correlation with coronary calcium score and high-sensitivity C-reactive protein

机译：高危无症状患者的单光子发射计算机断层扫描心肌缺血检测：与冠状动脉钙化评分和高敏C反应蛋白的相关性

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Background: The association between myocardial ischemia in high-risk patients with coronary calcium score (CCS) and high-sensitivity C-reactive protein (hs-CRP) is not well established. Aims: We evaluated the correlation between hs-CRP, CCS, and myocardial ischemia in asymptomatic high-risk patients without known coronary artery disease (CAD). Materials and Methods: We prospectively assessed 68 asymptomatic high-risk outpatients without known CAD. One-day rest-stress Tc-99m single-photon emission computed tomography (SPECT) myocardial perfusion imaging and multislice computed tomography were performed. Multivariate regression analysis was performed for the assessment of predictors of myocardial ischemia. Standard risk factors and hs-CRP values were analyzed. Results: CCS 0 Agatston score was observed in 26 patients (46.4%). Seven patients had CCS between 10 and 99 AU, 8 patients between 100 and 400 AU, and 11 patients had CCS 400 AU. Mild ischemia was noted in 11 patients, moderate ischemia in 10 patients, and severe ischemia in 6 patients. Hs-CRP was 1 mg/L in 39 patients, of whom 8 patients had CCS 0, 13 patients had normal SPECT results, 6 patients had mild ischemia, and 12 patients had moderate and severe ischemia. Multivariate regression analysis showed independent predictors for increased CCS: low-density lipoprotein cholesterol (odds ratio [OR]: 2.891; P = 0.001); age 70 years (OR: 2.568; P = 0.001); and smoking (OR: 1.931; P = 0.001). We found hs-CRP to be an independent predictor of myocardial ischemia (OR: 4.145; 95% confidence interval: 1.398–7.471, P = 0.001). Conclusion: hs-CRP was an independent predictor of myocardial ischemia. hs-CRP might improve the selection of high-risk asymptomatic patients for myocardial SPECT imaging.
机译：背景：冠状动脉钙化评分（CCS）的高危患者的心肌缺血与高敏C反应蛋白（hs-CRP）之间的关联尚不明确。目的：我们评估了无冠心病（CAD）的无症状高危患者中hs-CRP，CCS和心肌缺血之间的相关性。材料和方法：我们前瞻性评估了68例无已知CAD的无症状高危门诊患者。进行了一天的静息Tc-99m单光子发射计算机断层扫描（SPECT）心肌灌注成像和多层计算机断层扫描。进行多元回归分析以评估心肌缺血的预测因素。分析标准危险因素和hs-CRP值。结果：26例患者中CCS> 0 Agatston评分（46.4％）。 7例患者的CCS在10到99 AU之间，8例患者在100到400 AU之间，11例CCS> 400 AU。注意到轻度缺血11例，中度缺血10例，重度缺血6例。 39例患者中Hs-CRP> 1 mg / L，其中CCS> 0的8例，SPECT结果正常的13例，轻度缺血的6例，中度和重度缺血的12例。多元回归分析显示CCS升高的独立预测因子：低密度脂蛋白胆固醇（优势比[OR]：2.891; P = 0.001）;年龄> 70岁（或：2.568; P = 0.001）;和吸烟（或：1.931; P = 0.001）。我们发现hs-CRP是心肌缺血的独立预测因子（OR：4.145; 95％置信区间：1.398-7.471，P = 0.001）。结论：hs-CRP是心肌缺血的独立预测因子。 hs-CRP可能会改善对高危无症状患者进行心肌SPECT成像的选择。

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