刘晓怡,孙超,程瑾,綦维维,洪楠,王屹.冠状动脉周围脂肪参数联合临床指标预测急性冠状动脉综合征主要不良心血管事件[J].中国医学影像技术,2023,39(8):1191~1195
冠状动脉周围脂肪参数联合临床指标预测急性冠状动脉综合征主要不良心血管事件
Pericoronary adipose tissue parameters combined with clinical indicators for predicting major adverse cardiovascular events of acute coronary syndrome
投稿时间:2023-03-23  修订日期:2023-05-19
DOI:10.13929/j.issn.1003-3289.2023.08.015
中文关键词:  冠状动脉疾病  急性冠脉综合征  冠状血管造影术  冠状动脉周围脂肪组织  主要不良心血管事件
英文关键词:coronary artery disease  acute coronary syndrome  coronary angiography  pericoronary adipose tissue  major adverse cardiovascular events
基金项目:北京大学人民医院研究与发展基金(RDJ2022-35)。
作者单位E-mail
刘晓怡 北京大学人民医院放射科, 北京 100044  
孙超 北京大学人民医院放射科, 北京 100044  
程瑾 北京大学人民医院放射科, 北京 100044  
綦维维 北京大学人民医院放射科, 北京 100044  
洪楠 北京大学人民医院放射科, 北京 100044  
王屹 北京大学人民医院放射科, 北京 100044 wang_yi@bjmu.edu.cn 
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中文摘要:
      目的 探讨冠状动脉周围脂肪组织(PCAT)脂肪衰减指数(FAI)联合临床指标预测急性冠状动脉综合征(ACS)患者发生主要不良心血管事件(MACE)的价值。方法 回顾性分析186例首诊ACS患者,根据随访发生MACE与否将其分为MACE组和无MACE组。采用单因素分析和多因素logistic 回归分析临床资料、实验室指标及冠状动脉CT血管造影(CCTA)所示冠状动脉主要分支左前降支(LAD)、左旋支(LCX)、右冠状动脉(RCA)狭窄程度、斑块性质及PCAT体积和FAI,筛选ACS发生MACE的独立预测因素;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价单一独立预测因素及其联合的预测效能。结果 MACE组35例,无MACE组151例。RCA-FAI(OR=0.127)及高密度脂蛋白胆固醇(HDL)(OR=1.098)是ACS MACE的独立预测因素(P均<0.05)。以RCA-FAI预测ACS MACE的AUC为0.671,HDL的AUC为0.371,二者联合AUC为0.709。结论 RCA-FAI联合HDL可用于预测ACS患者发生MACE。
英文摘要:
      Objective To explore the predictive value of pericoronary adipose tissue (PCAT) fat attenuation index (FAI) combined with clinical indicators for predicting major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS). Methods Data of 186 patients with initial diagnosed ACS were retrospectively analyzed. The patients were divided into MACE group or non-MACE group according to the occurrence of MACE or not during following-up. Univariate analysis and multivariate logistic regression analysis were used to analyze clinical data, laboratory indicators, as well as stenosis degree, plaque nature, the volume and FAI of PCAT of left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA) showed on coronary CT angiography (CCTA), and the independent predictive factors for MACE in patients with ACS were screened. Receiver operating characteristic (ROC) curves were drawn, and areas under the curve (AUC) were calculated to evaluate the predictive efficacy of independent predictive factors individually and in combination. Results There were 35 cases in MACE group and 151 cases in non-MACE group, respectively. RCA-FAI (OR=0.127) and high density lipoprotein cholesterol (HDL) (OR=1.098) were both independent predictive factors for MACE in patients with ACS (both P<0.05). AUC of RCA-FAI for predicting occurrence of MACE in patients with ACS was 0.671, of HDL was 0.371,while of their combination was 0.709. Conclusion RCA-FAI combined with HDL could predict occurrence of MACE in patients with ACS.
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