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首页> 外文期刊>The American Journal of Cardiology >Usefulness of Regional Distribution of Coronary Artery Calcium to Improve the Prediction of All-Cause Mortality
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Usefulness of Regional Distribution of Coronary Artery Calcium to Improve the Prediction of All-Cause Mortality

机译：冠状动脉钙的区域分布对改善全因死亡率的预测的有用性

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Although the traditional Agatston coronary artery calcium (CAC) score is a powerful predictor of mortality, it is unknown if the regional distribution of CAC further improves cardiovascular risk prediction. We retrospectively studied 23,058 patients referred for Agatston CAC scoring, of whom 61% had CAC (n = 14,084). CAC distribution was defined as the number of vessels with CAC (0 to 4, including left main). For multivessel CAC, "diffuse" CAC was defined by decreasing percentage of CAC in the single most affected vessel and by <= 75% total Agatston CAC score in the most calcified vessel. All-cause mortality was ascertained through the social security death index. The mean age was 55 +/- 11 years, with 69% men. There were 584 deaths (2.5%) over 6.6 +/- 1.7 years. Considerable heterogeneity existed between the Agatston CAC score group and the number of vessels with CAC. In each CAC group, increasing number Of vessels with CAC was associated with an increased mortality rate. After adjusting for age, gender, Agatston CAC score, and cardiovascular risk factors, increasing number of vessels with CAC was associated with higher mortality risk compared with single-vessel CAC (2-vessel: HR 1.61 [95% CI 1.14 to 2.25], 3-vessel: 1.99 [1.44 to 2.77], and 4-vessel: 2.22 [1.53 to 3.23]). "Diffuse" CAC was associated with a higher mortality rate in the CAC 101 to 400 and >400 groups. Left main CAC was associated with increased mortality risk. In conclusion, increasing number of vessels with CAC and left main CAC predict increased all-cause mortality and improve the prognostic power of the traditional Agatston CAC score. (C) 2015 Elsevier Inc. All rights reserved.
机译：尽管传统的Agatston冠状动脉钙（CAC）评分是死亡率的有力预测指标，但尚不清楚CAC的区域分布是否进一步改善心血管疾病风险预测。我们回顾性研究了23,058例接受Agatston CAC评分的患者，其中61％患有CAC（n = 14,084）。 CAC分布定义为具有CAC的血管数量（0至4，包括左主干）。对于多支血管CAC，“扩散” CAC的定义是减少单个受影响最大的血管中CAC的百分比，而钙化程度最高的血管中Agatston CAC总分<= 75％。全因死亡率是通过社会保障死亡指数确定的。平均年龄为55 +/- 11岁，男性占69％。在6.6 +/- 1.7年内，有584例死亡（2.5％）。 Agatston CAC评分组与患有CAC的血管数量之间存在相当大的异质性。在每个CAC组中，具有CAC的血管数量增加与死亡率增加相关。在调整了年龄，性别，Agatston CAC评分和心血管危险因素后，与单支血管CAC相比，伴有CAC的血管数目增加与更高的死亡风险相关（2支血管：HR 1.61 [95％CI 1.14至2.25]， 3船：1.99 [1.44至2.77]和4船：2.22 [1.53至3.23]）。 “弥散性” CAC与CAC 101至400和> 400组的较高死亡率相关。左主CAC与死亡风险增加相关。总之，伴有CAC和左主CAC的血管数量增加，预示了全因死亡率增加，并改善了传统Agatston CAC评分的预后能力。 （C）2015 Elsevier Inc.保留所有权利。

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