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首页> 外文期刊>Academic radiology >Prevalence and clinical characteristics of symptomatic patients with obstructive coronary artery disease in the absence of coronary calcifications.
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Prevalence and clinical characteristics of symptomatic patients with obstructive coronary artery disease in the absence of coronary calcifications.

机译：没有冠状动脉钙化的有症状的阻塞性冠状动脉疾病患者的患病率和临床特征。

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RATIONALE AND OBJECTIVES: The quantification of coronary calcification has established itself as a valid risk marker to predict cardiovascular events. However, data derived from cardiac multi-detector row computed tomography could demonstrate that the exclusion of coronary calcification is not synonymous with the exclusion of coronary artery disease (CAD). The aims of this retrospective analysis were to determine the prevalence of significant CAD in a symptomatic cohort with indications for invasive angiography but without coronary calcification (Agatston score 0) as assessed by multislice computed tomography and to investigate whether there were any differences in terms of risk factors between patients with and without significant CAD. MATERIALS AND METHODS: Five hundred multislice computed tomographic scans (in 371 men and 129 women) were included in the analysis. Agatston scores were determined on native scans. All patients underwent coronary angiography to detect or rule out obstructive CAD. Patients with negative calcium scoring were selected and divided into two subgroups: those without obstructive CAD and those with obstructive CAD (luminal stenoses > 50%). These subgroups were characterized in terms of clinical characteristics (age and sex) and cardiovascular risk factors (diabetes mellitus, hypertension, hyperlipoproteinemia, familial predisposition, smoking, and overweight). RESULTS: Sixty-one of 500 patients (12.2%) had negative calcium scores (Agatston score 0). Sixteen of these patients (26.3%, or 3.2% of the total population) had obstructive CAD according to invasive angiography. Patients with obstructive CAD were significantly older (mean age, 64 +/- 9 vs 55 +/- 10 years; P = .003) and were more frequently diabetic (25% vs 4%, P = .0389) than patients without obstructive CAD. There were no significant differences with regard to the other risk factors. CONCLUSIONS: In this high-risk population, the absence of coronary calcification was not sufficient to rule out CAD. Among patients without coronary calcification, the presence of significant CAD was associated with increased age and the presence of diabetes mellitus.
机译：理由和目的：冠状动脉钙化的量化本身已成为预测心血管事件的有效危险标志。但是，来自心脏多探测器行计算机断层扫描的数据可能表明排除冠状动脉钙化与排除冠状动脉疾病（CAD）并不等同。这项回顾性分析的目的是确定有症状的队列中有显着CAD的患病率，并通过多层计算机体层摄影术评估，该症状具有侵入性血管造影的指征，但无冠脉钙化（Agatston评分0），并调查是否存在风险差异有无CAD的患者之间的因素。材料与方法：该分析包括500多层计算机断层扫描（在371名男性和129名女性中）。 Agatston分数是通过本机扫描确定的。所有患者均接受冠状动脉造影以检查或排除阻塞性CAD。选择钙阴性的患者，将其分为两个亚组：无阻塞性CAD的患者和阻塞性CAD（管腔狭窄> 50％）的患者。这些亚组的特征是临床特征（年龄和性别）和心血管危险因素（糖尿病，高血压，高脂蛋白血症，家族性倾向，吸烟和超重）。结果：500名患者中有61名（12.2％）钙阴性（阿加斯顿评分为0）。根据有创血管造影术，这些患者中有16名（占总人口的26.3％，即总人口的3.2％）患有阻塞性CAD。患有阻塞性CAD的患者比没有阻塞性CAD的患者明显更年长（平均年龄，64 +/- 9 vs 55 +/- 10岁; P = .003），并且患糖尿病的频率更高（25％vs 4％，P = .0389）。 CAD。其他风险因素无显着差异。结论：在这种高危人群中，冠状动脉钙化的缺乏不足以排除CAD。在没有冠状动脉钙化的患者中，显着的CAD的存在与年龄的增加和糖尿病的存在相关。

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