心血管疾病患者通过非心电图门控计算机断层扫描检测到的冠状动脉钙化的预后价值：回顾性队列研究

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2024-11-23 DOI:10.1016/j.ijcha.2024.101560

Tomitaka Wakaki, Yusuke Takagi, Yuto Ono, Ryosuke Kato, Ken Abe, Hiroyuki Watanabe

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引用次数: 0

摘要

背景通过心电图门控计算机断层扫描（ECG 门控 CT）检测到的冠状动脉钙化（CAC）与未来心血管事件之间的相关性已得到证实。非心电图门控计算机断层扫描（ECG-gated CT）操作简单，应用广泛，适合用于筛查。然而，通过非 ECG 标记 CT 观察到的 CAC 与心血管和非心血管事件之间的相关性仍不清楚。因此，我们研究了通过非ECG门控CT检测到的冠状动脉钙化与预后之间的关联。方法这项非随机、回顾性队列研究纳入了353名连续的心血管疾病患者（男/女229/124；平均年龄68.6±12.7岁），他们在2017年10月1日至2021年5月31日期间接受了非ECG门控CT检查。评估了 Agatston 评分与心血管和非心血管事件之间的相关性。Agatston评分分为三个梯度（低、中、高）并进行比较。主要终点是复合心血管事件，包括心源性死亡、心肌梗死、充血性心力衰竭住院、中风和意外心脏手术。中位随访期为 16.9 个月（四分位间范围为 2.2-38.6），83 名患者达到了主要终点，81 名患者达到了次要终点。Kaplan-Meier分析表明，Agatston评分高的患者心血管和非心血管事件的发生率明显高于Agatston评分低的患者（p < 0.001）。结论在这项研究中，使用非ECG门控CT获得的Agatston评分可预测心血管和非心血管事件。非 EGG 标记的 CT 可以很容易地进行，有助于早期发现事件发生率高的患者。

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Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study

Background

The correlation between coronary artery calcification (CAC) detected via electrocardiogram-gated computed tomography (ECG-gated CT) and future cardiovascular events has been well-established. Non-ECG-gated CT is simple and widely used, making it suitable for screening. However, the correlation between CAC observed via non-ECG-gated CT and cardiovascular and non-cardiovascular events remains unclear. Therefore, we examined the association between coronary calcification detected via non-ECG-gated CT and prognosis.

Methods

This non-randomized, retrospective cohort study included 353 consecutive patients with cardiovascular diseases (male/female 229/124; mean age, 68.6 ± 12.7 years) who underwent non-ECG-gated CT between October 1, 2017 and May 31, 2021. Correlations between the Agatston score and cardiovascular and non-cardiovascular events were evaluated. The Agatston scores were divided into three tertiles (low, intermediate, and high) and compared. The primary endpoint was composite cardiovascular events, including cardiac death, myocardial infarction, hospitalization for congestive heart failure, stroke, and unplanned cardiac surgery. The secondary endpoint was composite non-cardiovascular events, including non-cardiovascular death, cancer development, and hospitalization for a non-cardiovascular worsening event.

Results

During the median follow-up period of 16.9 (interquartile range, 2.2–38.6) months, 83 patients reached the primary endpoint, while 81 patients reached the secondary endpoint. Kaplan–Meier analysis indicated that patients with high Agatston scores had a significantly higher incidence of cardiovascular and non-cardiovascular events than those with low Agatston scores (p < 0.001).

Conclusions

In this study, the Agatston score obtained using non-ECG-gated CT predicted cardiovascular and non-cardiovascular events. Non-ECG-gated CT can be easily performed, aiding early detection in patients with high event rates.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.