Calcified Coronary Plaque and Flow Reserve: Nonredundant and Complimentary Markers of Cardiovascular Prognosis.
Calcified Coronary Plaque and Flow Reserve: Nonredundant and Complimentary Markers of Cardiovascular Prognosis.
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钙化冠状动脉斑块和血流储备：心血管预后的非冗余和补充标志物。
DOI：
10.1161/circimaging.122.014126
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Taqueti,VivianyR
中科院分区：
文献类型：
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作者：
Taqueti,VivianyR
近年来，非侵入性地可视化和量化动脉粥样硬化斑块的能力取得了进展，这导致了我们对冠状动脉疾病（CAD）理解的革命，挑战了病理学的经典定义，模糊了一级预防与二级预防之间的区别。通过计算机断层扫描使用冠状动脉钙（CAC）量化钙化斑块负荷已成为无症状个体心血管结局的简单而可靠的预测因子。美国心脏协会/美国心脏病学会的2018年血液胆固醇管理1和2019年心血管疾病一级预防2指南均将CAC测量作为IIa类建议，以完善对具有临界或中等估计10年动脉粥样硬化性心血管疾病风险的个体的风险评估。与其他亚临床影像学标记物（如颈动脉内膜中层厚度）或生物标记物（如高敏C反应蛋白）相比，CAC具有上级鉴别力和风险重新分类能力，3、4 CAC为零时，可识别心血管事件和死亡风险较低的个体。5
Recent advancements in the ability to visualize and quantify atherosclerotic plaque noninvasively are leading to a revolution in our understanding of coronary artery disease (CAD), challenging classic definitions of pathology and blurring distinctions between primary versus secondary prevention. Quantification of calcified plaque burden using coronary artery calcium (CAC) via computed tomography has emerged as a simple and robust predictor of cardiovascular outcomes in asymptomatic individuals. Both the 2018 Management of Blood Cholesterol1 and 2019 Primary Prevention of Cardiovascular Disease2 guidelines of the American Heart Association/American College of Cardiology included measurement of CAC as a class IIa recommendation to refine risk assessment in individuals with borderline or intermediate estimated 10-year risk of atherosclerotic cardiovascular disease. CAC has superior discrimination and risk reclassification as compared with other subclinical imaging markers such as carotid intima-media thickness or biomarkers such as high-sensitivity C-reactive protein, 3, 4 and a CAC of zero identifies individuals at lower risk of cardiovascular events and death. 5