Clinical significance of the coronary calcification score by multidetector row computed tomography for the evaluation of coronary stenosis in Japanese patients
Clinical significance of the coronary calcification score by multidetector row computed tomography for the evaluation of coronary stenosis in Japanese patients
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DOI：
10.1253/circj.70.1122
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发表时间：
2006-09-01
影响因子：
3.3
通讯作者：
Saku, Keijiro
中科院分区：
文献类型：
--
作者：
Mitsutake, Ryoko;Niimura, Hideya;Saku, Keijiro
多排计算机断层扫描（MDCT）测量冠状动脉钙化（CAC）评分已成为预测冠状动脉疾病（CAD）的一种标志。为了评估CAC评分的临床意义，我们将冠状动脉造影（CAG）评估的冠状动脉狭窄程度与MDCT、危险因素和用药测定的CAC评分进行比较。方法与结果374例连续行多层螺旋CT血管造影的患者。CAC评分为400的患者的准确率为84%，明显低于CAC评分为0的患者。此外，选择92例在1个月内接受MDCT和CAG检查的患者（男性68例，女性24例，平均年龄63.11岁）进行进一步研究。冠脉明显狭窄患者的CAC评分明显高于无狭窄患者。此外，血管狭窄数量越多，CAC评分越高。按CAC评分分为低（0-12）、中（13-444）、高（>= 445）3组。CAC评分与年龄、血浆总胆固醇和血红蛋白a1c水平显著相关，logistic回归分析显示，CAG评估的明显冠状动脉狭窄与CAC评分最密切相关（p=0.03）。结论当冠状动脉狭窄因严重钙化而无法诊断时，MDCT测定CAC评分可独立于年龄、代谢性疾病、药物等其他因素预测冠心病。
Background The coronary artery calcification (CAC) score measured by multidetector row computed tomography (MDCT) has emerged as a marker for predicting coronary artery disease (CAD). To evaluate the clinical significance of the CAC score, coronary artery stenosis as assessed by coronary angiography (CAG) was compared with the CAC score determined by MDCT, risk factors and medications.Methods and Results Subjects included 374 consecutive patients who underwent ECG-gate CT angiography using MDCT. The accuracy in patients with a CAC score :400 was 84%, and significantly lower than that in patients with a CAC score =0. In addition 92 patients (68 males, 24 females; mean age, 63 11 years) who underwent both MDCT and CAG within a 1-month period were selected for further investigation. Patients with significant coronary stenosis had a significantly higher CAC score than those without stenosis. In addition, a higher number of stenosed vessels was associated with a higher CAC score. The subjects were divided into 3 groups according to the CAC score: low (0-12), intermediate (13-444) and high ( >= 445). The CAC score was significantly associated with age, and plasma levels of total cholesterol and hemoglobinA1c, and logistic regression analysis revealed that significant coronary stenosis as assessed by CAG was most closely correlated with the CAC score (p=0.03).Conclusions The CAC score determined by MDCT can predict CAD independent of other factors, such as age, metabolic diseases and medications, when coronary stenosis can not be diagnosed because of severe calcification.