Prediction of coronary events with electron beam computed tomography
Prediction of coronary events with electron beam computed tomography
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DOI：
10.1016/s0735-1097(00)00872-x
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发表时间：
2000-10-01
影响因子：
24
通讯作者：
Guerci, AD
中科院分区：
文献类型：
--
作者：
Arad, Y;Spadaro, LA;Guerci, AD
结论：我们试图确定电子束计算机断层扫描（EBCT）扫描冠状动脉在3至4年的预后准确性背景冠状动脉钙化评分与冠状动脉疾病的严重程度相关。然而，之前关于EBCT扫描对无症状个体冠状动脉事件的预后准确性的报道相互矛盾。方法接受冠状动脉EBCT的无症状男性和女性完成了初始和随访评估，其中包括既往病史、Rose心绞痛问卷和临时心血管事件。报告的冠状动脉事件（死亡，非致命性心肌梗死[MI]和血运重建手术）在不知道扫描结果的情况下得到证实。结果在1，177名合格受试者中的1，172名（99.6%）中获得了信息（基线年龄53 ± 11岁，71%男性）。在平均3.6年的随访中，39例受试者发生了冠状动脉事件：3例冠状动脉死亡，15例非致命性MI和21例冠状动脉血运重建术。发生事件的受试者的平均冠状动脉钙化评分为764 +/- 935，而未发生事件的受试者的平均冠状动脉钙化评分为135 +/- 432（p < 0.0001）。对于所有冠状动脉事件和非致命性MI和死亡的预测，受试者-操作者特征曲线下面积分别为0.84和0.86，冠状动脉钙化评分大于或等于160与比值比分别为15.8和22.2。调整自我报告的心血管危险因素后，所有事件的比值比仍然很高（14.3至20.2）。结论在无症状成人中，冠状动脉EBCT可预测冠状动脉死亡和非致命性MT以及血运重建手术的需要。CT Am Coil Cardiol 2000;36：1253-60）（C）2000，美国心脏病学会。
OBJECTIVES We sought to determine the prognostic accuracy of electron beam computed tomographic (EBCT) scanning of the coronary arteries at three to four years.BACKGROUND Coronary artery calcium scores determined by EBCT correlate with the severity of coronary artery disease. However, previous reports of the prognostic accuracy of EBCT scanning for coronary events in asymptomatic individuals are conflicting.METHODS Asymptomatic men and women undergoing coronary EBCT completed initial and follow-up evaluations, which included past medical history, the Rose angina questionnaire and interim cardiovascular events. Reported coronary events (death, nonfatal myocardial infarction [MI] and revascularization procedures) were confirmed without knowledge of the scan results.RESULTS Information was obtained in 1,172 (99.6%) of 1,177 eligible subjects (baseline age 53 +/- 11 years, 71% men). During an average follow-up of 3.6 years, 39 subjects sustained coronary events: three coronary deaths, 15 nonfatal MIs and 21 coronary artery revascularization procedures. The mean coronary artery calcium score was 764 +/- 935 among subjects with events as compared with 135 +/- 432 among those without events (p < 0.0001). For the prediction of all coronary events and of nonfatal MIs and deaths, the areas under the receiver-operator characteristics curve were 0.84 and 0.86, respectively, and a coronary calcium score greater than or equal to 160 was associated with odds ratios of 15.8 and 22.2, respectively. The odds ratios for all events remained high (14.3 to 20.2) after adjustment for self-reported cardiovascular risk factors.CONCLUSIONS In asymptomatic adults, EBCT of the coronary arteries predicts coronary death and nonfatal MT and the need for revascularization procedures. CT Am Coil Cardiol 2000;36:1253-60) (C) 2000 by the American College of Cardiology.