Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study.
Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study.
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DOI：
10.1161/jaha.120.019235
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发表时间：
2021-02-02
影响因子：
5.4
通讯作者：
Jang IK
中科院分区：
文献类型：
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作者：
Nakajima A;Araki M;Kurihara O;Minami Y;Soeda T;Yonetsu T;Higuma T;Kakuta T;McNulty I;Lee H;Malhotra R;Nakamura S;Jang IK
冠状动脉钙化在心血管事件和斑块稳定性中的作用仍在争论中，参与冠状动脉钙化进展的因素尚未完全了解。本研究旨在确定冠状动脉钙化快速进展的预测因素。选择在基线和6个月时具有连续光学相干断层扫描成像的患者。研究了钙化指数的变化和钙化进展的预测因素。钙化指数定义为平均钙化弧与钙化长度的乘积。钙化快速进展定义为钙化指数增加超过中位数。在187例接受连续光学相干断层扫描成像的患者中，105例患者（56.1%）在基线时发现了235个钙化斑块。6个月后95.3%的钙化斑块钙化指数由132.0增加到178.2（P<0.001）。在多变量分析中，发现糖尿病（比值比[OR]，3.911; P<0.001）、慢性肾脏疾病（OR，2.432; P=0.037）、富脂斑块（OR，2.698; P=0.034）和巨噬细胞（OR，6.782; P<0.001）是冠状动脉钙化快速进展的独立预测因子。有趣的是，钙化的快速进展与炎症特征的显著减少相关（薄帽纤维粥样硬化;从21.2%降至11.9%，P=0.003;巨噬细胞;从74.6%降至61.0%，P=0.001）。糖尿病、慢性肾脏疾病、富脂斑块和巨噬细胞是冠状动脉钙化快速进展的独立预测因素。基线血管炎症和随后的稳定可能与钙化的快速进展有关。URL：https://www.clinicaltrials.gov;唯一标识符：NCT 01110538。
The role of coronary calcification in cardiovascular events and plaque stabilization is still being debated, and factors involved in the progression of coronary calcification are not fully understood. This study aimed to identify the predictors for rapid progression of coronary calcification. Patients with serial optical coherence tomography imaging at baseline and at 6 months were selected. Changes in the calcification index and predictors for progression of calcification were studied. Calcification index was defined as the product of the mean calcification arc and calcification length. Rapid progression of calcification was defined as an increase in the calcification index above the median value. Among 187 patients who had serial optical coherence tomography imaging, 235 calcified plaques were identified in 105 patients (56.1%) at baseline. After 6 months, the calcification index increased in 95.3% of calcified plaques from 132.0 to 178.2 (P<0.001). In multivariable analysis, diabetes mellitus (odds ratio [OR], 3.911; P<0.001), chronic kidney disease (OR, 2.432; P=0.037), lipid‐rich plaque (OR, 2.698; P=0.034), and macrophages (OR, 6.782; P<0.001) were found to be independent predictors for rapid progression of coronary calcification. Interestingly, rapid progression of calcification was associated with a significant reduction of inflammatory features (thin‐cap fibroatheroma; from 21.2% to 11.9%, P=0.003; macrophages; from 74.6% to 61.0%, P=0.001). Diabetes mellitus, chronic kidney disease, lipid‐rich plaque, and macrophages were independent predictors for rapid progression of coronary calcification. Baseline vascular inflammation and subsequent stabilization may be related to rapid progression of calcification. URL: https://www.clinicaltrials.gov; Unique identifier: NCT01110538.