Determinants and correlates of target lesion calcium in coronary artery disease: A clinical, angiographic and intravascular ultrasound study
Determinants and correlates of target lesion calcium in coronary artery disease: A clinical, angiographic and intravascular ultrasound study
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DOI：
10.1016/s0735-1097(96)00479-2
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发表时间：
1997-02-01
影响因子：
24
通讯作者：
Leon, MB
中科院分区：
文献类型：
--
作者：
Mintz, GS;Pichard, AD;Leon, MB
目标.本研究应用血管内超声和定量冠状动脉造影技术探讨冠状动脉病变相关钙与冠状动脉狭窄的危险因素、临床表现和造影严重程度的关系。无创性检查被推荐作为冠状动脉疾病的筛查试验，血管内超声检测组织钙已在体外得到验证。独立病历审查、介入前血管内超声成像和冠状动脉造影用于研究1，442例患者的原发性自体血管病变。根据先前发表的定量和定性方法对靶病变和参考节段进行评价，结果以平均值+/- SD表示。靶病变钙的角度为110 +/-109度，超声斑块负荷>0.75或血管造影直径狭窄>0.25的病变的钙患病率至少为65%，平均值>100度，中度病变的靶病变钙与血管造影重度病变的靶病变钙一样多，使用多变量线性回归分析，患者年龄，稳定（与不稳定型）心绞痛和血管内超声病变部位及参考节段斑块负荷（但不是血管造影直径狭窄）是靶病变钙的独立预测因子（所有p < 0.0001）。血管内超声分析显示，冠状动脉钙化与斑块负荷相关，但与管腔受损程度无关。因此，冠状动脉钙化的无创检测可预测未来的心脏事件，这可能是因为冠状动脉钙化是总体动脉粥样硬化斑块负荷的标志物。冠状动脉钙化随患者年龄增加而增加，在不稳定病变亚组中不太常见。(C)1997年，美国心脏病学会。
Objectives. This report used intravascular ultrasound and quantitative coronary angiography to explore the relation between lesion-associated calcium and risk factors, clinical presentation and angiographic severity of coronary artery stenoses,Background, Coronary artery calcium is a marker for significant coronary atherosclerosis. Noninvasive procedures are being proposed as screening tests for coronary artery disease, Intravascular ultrasound identification of tissue calcium has been validated in vitro.Methods. Independent chart review, preintervention intravascular ultrasound imaging and coronary angiography were used to study primary native vessel lesions in 1,442 patients. Target lesions and reference segments were evaluated according to previously published quantitative and qualitative methods, Results are presented as mean value +/- SD.Results, Overall, 1,043 lesions contained target lesion calcium (72%); the are of target lesion calcium was 110 +/- 109 degrees, Lesions with an ultrasound plaque burden >0.75 or an angiographic diameter stenosis >0.25 had a prevalence of calcium of at least 65%, with a mean are >100 degrees, Intermediate lesions had as much target lesion calcium as did angiographically severe lesions, Using multivariate linear regression analysis, patient age, stable (vs. unstable) angina and the intravascular ultrasound lesion site and reference segment plaque burden (but not the angiographic diameter stenosis) were the independent predictors of the are of target lesion calcium (all p < 0.0001),Conclusions. Intravascular ultrasound analysis shows that coronary calcification correlates with plaque burden but not with degree of lumen compromise, Thus, the noninvasive detection of coronary calcium is predictive of future cardiac events, presumably because coronary calcification is a marker for overall atherosclerotic plaque burden, Coronary calcium increases with increasing patient age and is less common in unstable lesion subsets. (C) 1997 by the American College of Cardiology.