Relationship between cardiovascular risk factors and atherosclerotic disease burden measured by intravascular ultrasound
Relationship between cardiovascular risk factors and atherosclerotic disease burden measured by intravascular ultrasound
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DOI：
10.1016/j.jacc.2005.12.058
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发表时间：
2006-05-16
影响因子：
24
通讯作者：
Nissen, Steven E.
中科院分区：
文献类型：
--
作者：
Nicholls, Stephen J.;Tuzcu, E. Murat;Nissen, Steven E.
本研究的目的是确定心血管危险因素与冠状动脉粥样硬化斑块程度之间的关系。背景很少有数据存在相关的心血管危险因素与冠状动脉粥样硬化负荷的体积测量冠心病患者。方法临床特征，定量冠状动脉造影，和血管内超声（IVUS）进行了评价，在一项比较阿托伐他汀和普伐他汀的研究纳入的受试者。以1 mm的间隔测量斑块面积以计算动脉粥样硬化体积。确定内膜厚度异常（> 0.5 mm）的横截面百分比。结果：在654例受试者中，动脉粥样硬化体积平均为174.5 mm（3），动脉粥样硬化体积百分比为38.9%。在25，897个横截面中，81.2%存在动脉粥样硬化。在单变量分析中，糖尿病、男性、既往血运重建或卒中史与动脉粥样硬化体积百分比之间存在强相关性。高血压或既往心肌梗死也预示着更严重的疾病。低密度脂蛋白和C反应蛋白不是更大疾病负担的显著预测因子。在多变量分析中，糖尿病、男性和既往介入治疗史仍然是动脉粥样硬化体积增加的强预测因子。卒中史、非高加索人种和吸烟状态仍具有显著性。虽然多项措施IVUS疾病负担更糟的糖尿病患者，血管造影狭窄的严重程度是没有different.CONCLUSIONS男性性别，糖尿病，和历史的先前血运重建冠状动脉粥样硬化的负担在冠心病患者强的独立预测因子。许多危险因素不能预测血管造影疾病的严重程度，提示不同的机制驱动狭窄的发展和动脉粥样硬化的积累。（J Am科尔心脏病学杂志2006;47：1967-75）（c）美国心脏病学会基金会2006年。
OBJECTIVES The goal of this study was to determine the relationship between established cardiovascular risk factors and the extent of coronary atherosclerotic plaque.BACKGROUND Few data exist correlating cardiovascular risk factors with volumetric measurements of coronary atheroma burden in patients with coronary artery disease.METHODS Clinical characteristics, quantitative coronary angiography, and intravascular ultrasound (IVUS) were evaluated in subjects enrolled in a study comparing atorvastatin and pravastatin. Plaque areas were measured at 1-mm intervals to compute atheroma volume. The percent of cross sections with an abnormal intimal thickness (> 0.5 mm) was determined. Data on cardiovascular risk factors were collected.RESULTS In 654 subjects, atheroma volume averaged 174.5 mm(3) and percent atheroma volume 38.9%. Atherosclerosis was present in 81.2% of 25,897 cross sections. In univariate analysis, there was a strong association between diabetes, male gender, and a history of either prior revascularization or stroke with percent atheroma volume. Hypertension or prior myocardial infarction was also predictive of more severe disease. Low-density lipoprotein and C-reactive protein were not significant predictors of greater disease burden. In multivariate analysis, diabetes, male gender, and a history of a prior interventional procedure remained strong predictors of increased atheroma volume. History of stroke, non-Caucasian race, and smoking status remained significant. Although multiple measures of IVUS disease burden were worse in subjects with diabetes, angiographic stenosis severity was not different.CONCLUSIONS Male gender, diabetes, and a history of prior revascularization are strong independent predictors of atherosclerotic burden in coronary disease patients. Many risk factors did not predict angiographic disease severity, suggesting different mechanisms drive stenosis development and atheroma accumulation. (J Am Coll Cardiol 2006;47:1967-75) (c) 2006 by the American College of Cardiology Foundation.