Use of electron beam tomography data to develop models for prediction of hard coronary events
Use of electron beam tomography data to develop models for prediction of hard coronary events
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DOI：
10.1067/mhj.2001.113220
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发表时间：
2001-03-01
影响因子：
4.8
通讯作者：
Callister, TQ
中科院分区：
文献类型：
--
作者：
Raggi, P;Cooil, B;Callister, TQ
尽管已经确定了几个与冠状动脉疾病（CAD）发展相关的危险因素，但对严重心脏事件（心肌梗死和冠状动脉死亡）的预测仍然很困难。新的风险指标可能会增加我们的预测能力。我们使用通过电子束断层扫描（EBT）成像发现的冠状动脉钙化（CAC）的测量来开发单独的硬心脏事件以及与CAD的传统危险因素相关的硬心脏事件的预测模型。A组，无症状患者676例（平均年龄52岁，51%为男性）在初级保健医生转诊进行筛查EBT后前瞻性随访32 +/- 7个月，B组，10人，结果A组患者中困难事件的发生与CAD的传统危险因素、CAC的存在（评分>0）、Ln（1 +绝对钙评分[CS]）以及年龄和性别特异性CS百分位数（CS%）有关。单变量分析显示，年龄、吸烟、糖尿病、CAC的存在、in（1 +绝对CS）和CS%是硬事件的预测因素（均P <0.05）。多因素logistic回归分析显示CS%是唯一有意义的事件预测因子，当与CAD的传统危险因素结合时，CS %提供了增量的预后价值（卡方，P
Background Prediction of hard cardiac events (myocardial infarction and coronary death) remains difficult in spite of the identification of several relevant risk factors for the development of coronary artery disease (CAD). New indicators of risk might add to our predictive ability. We used measures of coronary artery calcification (CAC) found by electron beam tomography (EBT) imaging to develop prediction models for hard cardiac events alone and in association with traditional risk factors for CAD.Methods Two groups of patients were studied: group A, 676 asymptomatic patients (mean age 52 years, 51% men) prospectively followed up For 32 +/- 7 months after being referred by primary care physicians for a screening EBT, and group B, 10,122 asymptomatic patients screened by EBT at one center and used as controls for calculation of calcium score nomograms.Results The occurrence of hard events in group A patients was related to traditional risk factors for CAD, presence of CAC (score >0), Ln (1 + absolute calcium score [CS]), and age- and sex-specific CS percentiles (CS%). Univariate analyses showed that age, smoking, diabetes mellitus, presence of CAC, in (1 + absolute CS), and CS% were predictive of hard events (all P < .05). Multiple logistic regression analyses demonstrated that CS% was the only significant predictor of events and provided incremental prognostic value when added to traditional risk factors for CAD (chi-square, P