Int J Cardiol:冠状动脉钙化评分对有症状个体的预后价值

2019-06-04 xing.T 网络

由此可见,这项荟萃分析表明CAC水平升高与稳定的、有症状的疑似CAD患者的MACE风险增加强烈且独立相关,CAC评分越高,风险越大。应用CAC扫描作为预测方法对于相当多的此类患者可能是有用的。

冠状动脉钙化(CAC)扫描已经发展成为无症状受试者血管疾病的重要亚临床预测方法。然而,CAC扫描在有症状个体中的预后意义尚不清楚。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员旨在评估CAC在预测可疑CAD患者的主要心脏不良事件(MACE)风险的预后效用。

研究人员对CAC评分中的原始数据进行了系统的电子文献检索,并将稳定的、有症状的患者的心血管事件报告为主要结局。荟萃分析的主要结果是MACE的发生、MACE晚期冠状动脉血运重建、不稳定型心绞痛住院或心力衰竭、非致死性心肌梗死、心源性死亡或全因死亡率。使用随机效应模型,研究人员汇总了CAC对MACE的相对风险比,并调整了不同CAC分层(CAC为0-100、100-400、≥400、CAC=0)和MACE之间关联的风险比(HR)。

研究人员纳入了19项观察性研究(n=34041)。总共分析了1601个事件,其中CAC=0的患者有158名,CAC>0的患者汇总相对风险比为5.71(95%CI为3.98-8.19)。调整后的HR汇总估计值显示增加,并且为正相关,CAC>400关联最强(HR为4.88; 95%CI为2.44-9.27)。

由此可见,这项荟萃分析表明CAC水平升高与稳定的、有症状的疑似CAD患者的MACE风险增加强烈且独立相关,CAC评分越高,风险越大。应用CAC扫描作为预测方法对于相当多的此类患者可能是有用的。 

原始出处:

Mallory S.Lo-Kioeng-Shioe,et al.Prognostic value of coronary artery calcium score in symptomatic individuals: A meta-analysis of 34,000 subjects.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.06.003

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