Relation Between Framingham Risk Categories and the Presence of Functionally Relevant Coronary Lesions as Determined on Multislice Computed Tomography and Stress Testing
Relation Between Framingham Risk Categories and the Presence of Functionally Relevant Coronary Lesions as Determined on Multislice Computed Tomography and Stress Testing
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DOI：
10.1016/j.amjcard.2009.05.010
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发表时间：
2009-09-15
影响因子：
2.8
通讯作者：
Bax, Jeroen J.
中科院分区：
文献类型：
--
作者：
Nucifora, Gaetano;Schuijf, Joanne D.;Bax, Jeroen J.
通过多层螺旋CT（MSCT）冠状动脉造影对亚临床动脉粥样硬化进行无创性评估，并通过负荷试验证明严重的血流限制性冠状动脉疾病（CAD）可能会改善患者的风险分层。然而，与这些机构提供的补充资料有关的数据。传统风险评估的非侵入性技术很少。在255例无已知CAD的受试者（45%为女性，平均年龄54 ± 12岁）中，进行了64层MSCT冠状动脉造影和负荷试验（运动心电图试验或心肌灌注成像）。根据基线特征（50%低，22%中等，28%高）计算脆性风险评分（FRS）。显示动脉粥样硬化的血管造影被分类为阻塞性（50%管腔狭窄）CAD或没有。压力测试分为正常和异常。多层计算机断层扫描识别出155例（61%）患有CAD的患者，其中78例（31%）表现为阻塞性CAD。36例（46%）梗阻性CAD患者的负荷试验结果为阳性。随着FRS分类的增加，观察到功能相关的梗阻性CAD的患病率显著增加（6%低vs 45%中等vs 63%高，p
Noninvasive assessment of subclinical atherosclerosis by multislice computed tomographic (MSCT) coronary angiography and demonstration of significant, flow-limiting coronary artery disease (CAD) by stress testing may improve patients risk stratification. However, data relating the complementary information provided by these. noninvasive techniques to traditional risk assessment are scarce. In 255 subjects (45% women, mean age 54 +/- 12 years) without known CAD, 64-slice MSCT coronary angiography and stress testing (exercise electrocardiographic test or myocardial perfusion imaging) were performed. Framingham risk score (FRS) was calculated from baseline characteristics (50% low, 22% intermediate, 28% high). Angiograms showing atherosclerosis were classified as obstructive ( 50% luminal narrowing) CAD or not. Stress tests were classified as normal or abnormal. Multislice computed tomogram identified 155 patients (61%) with CAD, of whom 78 (31%) showed obstructive CAD. A positive stress test result was observed in 36 patients (46%) with obstructive CAD. In line with increasing FRS categories, a significant increase in the prevalence of functionally relevant obstructive CAD was observed (6% low vs 45% intermediate vs 63% high, p