心血管

订阅

MedSci主页 / 所有栏目 / 心血管

JAMA：冠脉钙化密度大小与心血管疾病风险呈负相关

2014-01-20 箫砚 dxy

冠脉钙化密度心血管
关注

研究要点：1、目前对冠状动脉钙化（CAC）的标准评分为Agatston积分，冠脉钙化密度越高，得分越高。但是，一些数据显示，斑块密度增加对心血管疾病或有保护作用。2、本项研究结论如下，冠脉钙化（CAC）体积是冠心病（CHD）和心血管疾病（CVD）发病风险的独立影响因素，呈正相关。但是在相同CAC体积下，CAC密度与CHD和CVD呈显著负相关。在评价当前的一些CAC评分系统时，应该将CAC纳入考虑范

研究要点：

1、目前对冠状动脉钙化（CAC）的标准评分为Agatston积分，冠脉钙化密度越高，得分越高。但是，一些数据显示，斑块密度增加对心血管疾病或有保护作用。

2、本项研究结论如下，冠脉钙化（CAC）体积是冠心病（CHD）和心血管疾病（CVD）发病风险的独立影响因素，呈正相关。但是在相同CAC体积下，CAC密度与CHD和CVD呈显著负相关。在评价当前的一些CAC评分系统时，应该将CAC纳入考虑范围。

冠状动脉钙化（CAC）对心血管疾病有较强的预测价值，目前对冠状动脉钙化的标准评分为Agatston积分，冠脉钙化密度越高，得分越高。但是，一些数据显示，斑块密度增加对心血管疾病或有保护作用。因此，为明确冠脉钙化斑块的体积大小、密度大小与心血管事件之间的关系，研究人员进行了MESA研究（Multi-Ethnic Study of Atherosclerosis）。【原文下载】

该研究是一项多中心观察性研究，纳入了美国6家医学中心的3398名受试者，包括4个种族：非西班牙白种人、非裔美国人、西班牙人、华人。受试者年龄为45-84岁，无心血管疾病，存在一定程度冠脉钙化。观察的主要终点为发作性的冠状动脉性心脏病（CHD）以及所有的心血管事件（CVD）。
该研究平均随访7.6年，期间共发生265例心血管事件，包括175例冠心病事件及90例其他类型心血管事件。数据显示，冠脉钙化体积与CHD、CVD呈正比；但是钙化斑块密度却与CHD、CVD呈反比。
该研究的结论认为，冠脉钙化体积是CHD和CVD发病风险的独立影响因素，呈正相关。但是在相同CAC体积下，CAC密度与CHD和CVD呈显著负相关。在评价当前的一些CAC评分系统时，应该将CAC纳入考虑范围。

目前对CAC的标准评分是Agatston积分。Agatston积分是根据CT扫描断层下CAC的体积大小以及密度大小进行评分，但是在Agatston积分中，CAC密度越高，得分也越高。

尽管CAC对于心血管疾病发病风险具有很强的预测作用，但目前没有针对CAC非常严格的评分标准，并且也并不明确CAC密度越高，其总体评分越高是否合适。

越来越多的证据提示，随着CAC密度升高，CVD发病风险会降低。一些对比急性心血管疾病与稳定性心血管疾病的研究显示，稳定性心血管疾病中的钙化斑块密度更大。

近期的一项研究表明，对于绝大多数具有CAC斑块的患者，斑块已经钙化；而且斑块已钙化组别心血管疾病风险已显著低于斑块未钙化或钙化程度较小组别。一项关于他汀治疗的随机对照研究显示，他汀治疗组别患者CAC进展更多，这与稳定性斑块是一致的。

为明确CAC密度与CVD发病风险之间的相关度，研究人员选用了MESA研究(Multi-Ethnic Study of Atherosclerosis) 中的数据，并且经过分析发现CAC密度以及CAC体积与CVD发病风险是互相独立的。研究人员因此推断，在任何CAC斑块体积大小下，CAC密度与发作性心血管疾病之间呈现负相关。

原文出处：
Criqui MH1, Denenberg JO2, Ix JH3, McClelland RL4, Wassel CL5, Rifkin DE3, Carr JJ6, Budoff MJ7, Allison MA2.Calcium density of coronary artery plaque and risk of incident cardiovascular events.JAMA. 2014 Jan 15;311(3):271-8. doi: 10.1001/jama.2013.282535. 【原文下载】

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1472935, encodeId=837214e29351e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487181, encodeId=56f3148e1815b, content=<a href='/topic/show?id=624831013b1' target=_blank style='color:#2F92EE;'>#冠脉钙化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31013, encryptionId=624831013b1, topicName=冠脉钙化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16808291789, createdName=d830375, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497811, encodeId=6863149e8116b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573211, encodeId=cfb215e321114, content=<a href='/topic/show?id=34009226531' target=_blank style='color:#2F92EE;'>#负相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92265, encryptionId=34009226531, topicName=负相关)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c2115837741, createdName=hmwwww, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=)]
    2014-01-22 花花1368

    #疾病风险#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1472935, encodeId=837214e29351e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487181, encodeId=56f3148e1815b, content=<a href='/topic/show?id=624831013b1' target=_blank style='color:#2F92EE;'>#冠脉钙化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31013, encryptionId=624831013b1, topicName=冠脉钙化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16808291789, createdName=d830375, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497811, encodeId=6863149e8116b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573211, encodeId=cfb215e321114, content=<a href='/topic/show?id=34009226531' target=_blank style='color:#2F92EE;'>#负相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92265, encryptionId=34009226531, topicName=负相关)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c2115837741, createdName=hmwwww, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=)]
    2014-01-22 d830375

    #冠脉钙化#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1472935, encodeId=837214e29351e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487181, encodeId=56f3148e1815b, content=<a href='/topic/show?id=624831013b1' target=_blank style='color:#2F92EE;'>#冠脉钙化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31013, encryptionId=624831013b1, topicName=冠脉钙化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16808291789, createdName=d830375, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497811, encodeId=6863149e8116b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573211, encodeId=cfb215e321114, content=<a href='/topic/show?id=34009226531' target=_blank style='color:#2F92EE;'>#负相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92265, encryptionId=34009226531, topicName=负相关)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c2115837741, createdName=hmwwww, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=)]
    2014-01-22 仁者大医

    #血管疾病#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1472935, encodeId=837214e29351e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487181, encodeId=56f3148e1815b, content=<a href='/topic/show?id=624831013b1' target=_blank style='color:#2F92EE;'>#冠脉钙化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31013, encryptionId=624831013b1, topicName=冠脉钙化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16808291789, createdName=d830375, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497811, encodeId=6863149e8116b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573211, encodeId=cfb215e321114, content=<a href='/topic/show?id=34009226531' target=_blank style='color:#2F92EE;'>#负相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92265, encryptionId=34009226531, topicName=负相关)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c2115837741, createdName=hmwwww, createdTime=Wed Jan 22 04:53:00 CST 2014, time=2014-01-22, status=1, ipAttribution=)]
    2014-01-22 hmwwww

    #负相关#

    0