Relation of Infra-Renal Abdominal Aortic Calcific Deposits and Cardiovascular Events in Patients With Peripheral Artery Disease
Relation of Infra-Renal Abdominal Aortic Calcific Deposits and Cardiovascular Events in Patients With Peripheral Artery Disease
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DOI：
10.1016/j.amjcard.2009.10.067
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发表时间：
2010-03-15
影响因子：
2.8
通讯作者：
Golledge, Jonathan
中科院分区：
文献类型：
--
作者：
Parr, Adam;Buttner, Petra;Golledge, Jonathan
在外周动脉疾病患者中，主动脉钙化沉积是常见的发现。本研究的目的是评估肾下腹主动脉钙化沉积与外周动脉疾病患者心血管事件的相关性。采用计算机断层血管造影术对213例腹主动脉瘤或间歇性跛行患者进行了连续的评估。使用先前定义的高度可重复的半自动程序估计肾腹主动脉钙化沉积。对患者进行前瞻性随访，中位随访时间为2.8年（四分位数间距为1.7 - 3.6），并记录心血管事件。Kaplan-Meier和考克斯比例风险分析用于检查钙化沉积与心血管事件的相关性。随访期间共发生45起心血管事件，包括非致死性心肌梗死（n = 23）、冠状动脉血运重建（n = 6）、卒中（n = 3）、膝下截肢（n = 2）和心血管死亡（n = 11）。腹主动脉轻度钙化（1，700 mm（3））患者的心血管事件发生率分别为21.7%、33.0%和36.9%（p = 0.039）。钙化存款体积>400毫米（3）（相对危险度2.8，95%置信区间1.2至6.6）和冠状动脉疾病（相对危险度2.8，95%置信区间1.4至5.6）与随访期间心血管事件增加独立相关。总之，腹主动脉钙化沉积是外周动脉疾病患者心血管事件的预后因素。(C)2010年爱思唯尔公司All rights reserved. (Am J Cardiol 2010;105：895-899）
In patients with peripheral artery disease, aortic calcific deposits are a common finding. The aim of this study was to assess the association of infrarenal abdominal aortic calcific deposits with prospective cardiovascular events in patients with peripheral artery disease. A consecutive series of 213 patients who presented for investigation of abdominal aortic aneurysm or intermittent claudication were assessed using computed tomographic angiography. Infrarenal abdominal aortic calcific deposits were estimated using a previously defined highly reproducible semiautomated program. Patients were followed prospectively for a median of 2.8 years (interquartile range 1.7 to 3.6), and cardiovascular events were recorded. Kaplan-Meier and Cox proportional-hazards analysis were used to examine the association of calcific deposits with cardiovascular events. A total of 45 cardiovascular events occurred during follow-up, including nonfatal myocardial infarction (n = 23), coronary revascularization (n = 6), stroke (n = 3), below-knee amputation (n = 2), and cardiovascular death (n = 11). The incidence of cardiovascular events was 21.7%, 33.0%, and 36.9% for patients with mild (1,700 mm(3)) abdominal aortic calcific deposits, respectively (p = 0.039). Calcific deposit volume >400 mm(3) (relative risk 2.8, 95% confidence interval 1.2 to 6.6) and coronary artery disease (relative risk 2.8, 95% confidence interval 1.4 to 5.6) were independently associated with increased cardiovascular events during follow-up. In conclusion, abdominal aortic calcific deposits are prognostic for cardiovascular events in patients with peripheral artery disease. (C) 2010 Elsevier Inc. All rights reserved. (Am J Cardiol 2010;105:895-899)