冠状动脉钙评分是特发性肺纤维化患者死亡率的一个预后因素。

IF 4.7 4区 医学 0 MEDICINE, GENERAL & INTERNAL
Minerva medica Pub Date : 2023-12-01 Epub Date: 2022-06-07 DOI:10.23736/S0026-4806.22.08018-1
Antonella Caminati, Maurizio Zompatori, Nicoletta Fuccillo, Andrea Sonaglioni, Davide Elia, Roberto Cassandro, Roberta Trevisan, Anna Rispoli, Giuseppe Pelosi, Sergio Harari
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引用次数: 0

摘要

背景心血管疾病在特发性肺纤维化(IPF)中常见,并影响生存。我们研究了在IPF诊断和中期随访中冠状动脉钙(CAC)评分与心血管不良事件和全因死亡率的关系。方法对IPF患者进行回顾性分析。记录人口统计学数据、吸烟史、合并症和肺功能测试(PFTs)。所有患者至少间隔两年进行两次胸部高分辨率计算机断层扫描(HRCT)。计算CAC总分和视觉纤维化评分,并报告所有具有临床意义的心血管事件和死亡。结果该人群包括79名患者(57名男性,平均年龄74.4±7.6岁);67%的患者有吸烟史,48%有高血压史,37%有血脂异常史,22.8%有糖尿病史。T0和T1的视觉评分分别为21.28±7.99%和26.54±9.34%(T1-T0 5.26±6.13%,p<0.001)。T0和T1CAC评分分别为537.93±839.94和759.98±1027.6(T1-TO 224.66±406.87,p<001)。平均随访时间为2.47±1.1年。在多变量分析中,男性(HR 3.58,95%CI 1.14-11.2)和T0时CAC评分(HR 1.04,95%CI 1.01-1.07)与死亡率和心血管事件相关。T0≥405时的CAC评分对预测死亡率和心血管不良事件显示出82%的敏感性和100%的特异性。结论诊断时CAC评分≥405的SIPF患者在中期随访中预后较差。较高的CAC评分与死亡率和心血管事件相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coronary artery calcium score is a prognostic factor for mortality in idiopathic pulmonary fibrosis.

Background: Cardiovascular diseases are frequent in idiopathic pulmonary fibrosis (IPF) and impact on survival. We investigated the association of coronary artery calcium (CAC) score at IPF diagnosis and during mid-term follow-up, with adverse cardiovascular events and all-cause mortality.

Methods: Consecutive patients with IPF were retrospectively analyzed. Demographic data, smoking history, comorbidities and pulmonary function tests (PFTs) were recorded. All patients had at least two chest high resolution computed tomography (HRCT) performed 2 years apart. The total CAC score and visual fibrotic score were calculated, and all clinically significant cardiovascular events and deaths were reported.

Results: The population consisted of 79 patients (57 males, mean age: 74.4±7.6 years); 67% of patients had a history of smoking, 48% of hypertension, 37% of dyslipidemia and 22.8% of diabetes. The visual score was 21.28±7.99% at T0 and 26.54±9.34% at T1, respectively (T1-T0 5.26±6.13%, P<0.001). CAC score at T0 and at T1 was 537.93±839.94 and 759.98±1027.6, respectively (T1-T0 224.66±406.87, P<0.001). Mean follow-up time was 2.47±1.1 years. On multivariate analysis, male sex (HR=3.58, 95% CI: 1.14-11.2) and CAC score at T0 (HR=1.04, 95% CI: 1.01-1.07) correlated with mortality and cardiovascular events. CAC score at T0≥405 showed 82% sensitivity and 100% specificity for predicting mortality and adverse cardiovascular events.

Conclusions: IPF patients with a CAC score at diagnosis ≥405 have a poor prognosis over a mid-term follow-up. A higher CAC score is associated with mortality and cardiovascular events.

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来源期刊
Minerva medica
Minerva medica 医学-医学:内科
CiteScore
6.40
自引率
6.40%
发文量
358
审稿时长
>12 weeks
期刊介绍: Minerva Medica publishes scientific papers on internal medicine. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics.
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