Silent Coronary Artery Disease in Japanese Patients Undergoing Carotid Artery Stenting
Silent Coronary Artery Disease in Japanese Patients Undergoing Carotid Artery Stenting
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DOI：
10.1016/j.jstrokecerebrovasdis.2012.12.013
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发表时间：
2013-10-01
影响因子：
2.5
通讯作者：
Iwama, Toru
中科院分区：
文献类型：
--
作者：
Enomoto, Yukiko;Yoshimura, Shinichi;Iwama, Toru
背景资料：这项回顾性研究的目的是确定日本接受颈动脉支架植入术（CAS）患者中无症状冠状动脉疾病（CAD）的患病率以及与伴随CAD相关的风险因素。研究方法：回顾性分析了2006年1月至2011年1月期间在我院接受选择性CAS治疗颅外颈动脉狭窄的112例连续患者（99例男性和13例女性;平均年龄70 ± 8岁）的记录。在此期间，所有患者均进行了术前冠状动脉造影CAD筛查。当≥ 1支冠状动脉狭窄≥ 75%时，患者被诊断为CAD，并被分为2组：（1）基于术前冠状动脉造影或经皮冠状动脉介入治疗（PCI）和/或冠状动脉旁路移植术（CABG）史的CAD组，和（2）无冠状动脉造影记录狭窄> 75%的无CAD组。结果：16例（14.3%）患者患有CAD，已接受PCI和/或CABG治疗。112例患者中有39例（34.8%）检测到无症状性CAD。总之，55例（49.1%）患者患有临床显著CAD。CAD患者更可能患有糖尿病（DM; P = 0.001）、血脂异常（P = 0.013）和双侧颈动脉疾病（P = 0.033）。多变量分析显示，DM（比值比3.07; 95%置信区间1.25-7.53）和双侧颈动脉狭窄（比值比2.72; 95%置信区间1.10-6.75）是与合并CAD相关的独立变量。结论：围手术期CAD筛查显示，在计划接受CAS的日本患者中，尤其是患有DM和/或双侧颈动脉狭窄的患者中，经常诊断出无症状CAD。
Background: The aim of this retrospective study was to determine the prevalence of silent coronary artery disease (CAD) and the risk factors associated with concomitant CAD in Japanese patients undergoing carotid artery stenting (CAS). Methods: The records of 112 consecutive patients (99 men and 13 women; mean age 70 +/- 8 years) who underwent elective CAS at our institution for extracranial carotid artery stenosis between January 2006 and January 2011 were reviewed retrospectively. During this period, preoperative CAD screening by coronary angiography was performed in all patients. Patients were diagnosed with CAD when >= 1 coronary arteries had stenosis >= 75% and were classified into 2 groups: (1) a group with CAD that was based on preoperative coronary angiography or a history of percutaneous coronary intervention (PCI) and/or coronary artery bypass grafting (CABG), and (2) a group without CAD that had no angiographically documented stenosis >75%. Results: Sixteen (14.3%) patients had CAD that had already been treated by PCI and/or CABG. Silent CAD was detected in 39 (34.8%) of 112 patients. Taken together, 55 (49.1%) patients had clinically significant CAD. The patients with CAD were more likely to have diabetes mellitus (DM; P = .001), dyslipidemia (P = .013), and bilateral carotid disease (P = .033). Multivariate analysis revealed that DM(odds ratio 3.07; 95% confidence interval 1.25-7.53) and bilateral carotid stenosis (odds ratio 2.72; 95% confidence interval 1.10-6.75) were independent variables associated with concomitant CAD. Conclusions: Perioperative CAD screening revealed that silent CAD was frequently diagnosed in Japanese patients scheduled for CAS, particularly in those with DM and/or bilateral carotid stenosis.