Carotid artery intima-media thickness and plaque score can predict the SYNTAX score
Carotid artery intima-media thickness and plaque score can predict the SYNTAX score
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DOI：
10.1093/eurheartj/ehr399
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发表时间：
2012-01-01
影响因子：
39.3
通讯作者：
Sugi, Kaoru
中科院分区：
文献类型：
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作者：
Ikeda, Nobutaka;Kogame, Norihiro;Sugi, Kaoru
颈动脉超声（carotid-US）检查结果与冠状动脉疾病复杂程度之间的关系报道较少。我们的目的是研究颈动脉-US结果和严重程度的SYNTAX评分（SXscore）之间的关系。方法和结果受试者是501例连续患者进行颈动脉-US和第一次冠状动脉造影从2008年12月至2011年1月。采用颈动脉超声检测颈总动脉平均内膜中层厚度（meanIMT）和斑块评分（PS）。低（0-22）、中等（23-32）和高（>= 33）SX评分患者的患病率分别为84.8%、7.4%和7.8%。SX评分与平均IMT（斯皮尔曼等级相关系数; rho = 0.442，P < 0.0001）和PS（rho = 0.544; P < 0.0001）相关。与平均IMT和PS预测中等或高SX评分相关的比值比分别为1.24和1.31。平均IMT和PS预测中等或高SX评分的受试者工作特征曲线下面积分别为0.791和0.846。当我们设定平均IMT为0.9 mm的临界值时，对于中等或高SX评分的敏感性为92.1%。同样，PS 5的临界水平显示灵敏度为96.1%。平均IMT>= 0.9mm和PS >= 5对中、高SX评分的阴性预测值分别为97.3%和98.6%。此外，PS和平均IMT对复杂冠状动脉病变的存在显示出极好的阴性预测值。
Aims There are few reports demonstrating a relationship between carotid artery ultrasound (carotid-US) findings and the complexity of coronary artery disease. We aimed to examine the relationship between carotid-US findings and the severity of the SYNTAX score (SXscore).Methods and results Subjects were 501 consecutive patients who underwent carotid-US and first coronary angiography from December 2008 to January 2011. Carotid-US was used to determine the mean common carotid artery intima-media thickness (meanIMT) and the plaque score (PS). The prevalences of low (0-22), intermediate (23-32), and high (>= 33) SXscore patients were 84.8, 7.4, and 7.8%, respectively. The SXscore was correlated with the meanIMT (Spearman's rank correlation coefficient; rho = 0.442, P < 0.0001) and the PS (rho = 0.544; P < 0.0001). The odds ratios associated with the meanIMT and the PS for prediction of an intermediate or the high SXscore were 1.24 and 1.31, respectively. The areas under the receiver-operating characteristic curves for the meanIMT and the PS to predict the intermediate or the high SXscore were 0.791 and 0.846, respectively. When we set the cut-off value of a meanIMT of 0.9 mm, the sensitivity was 92.1% for intermediate or the high SXscore. Similarly, a cut-off level of a PS of 5 presented a sensitivity of 96.1%. A meanIMT >= 0.9 mm and a PS >= 5 had negative predictive values of 97.3 and 98.6%, respectively, for intermediate or high SXscore.Conclusion Carotid-US parameters have predictive value for the SXscore. In addition, the PS and the meanIMT showed excellent negative predictive value for the presence of complex coronary artery lesions.