CORONARY CALCIUM, AS DETERMINED BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY, AND CORONARY-DISEASE ON ARTERIOGRAM - EFFECT OF PATIENTS SEX ON DIAGNOSIS
CORONARY CALCIUM, AS DETERMINED BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY, AND CORONARY-DISEASE ON ARTERIOGRAM - EFFECT OF PATIENTS SEX ON DIAGNOSIS
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DOI：
10.1161/01.cir.91.5.1363
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发表时间：
1995-03-01
期刊：
影响因子：
37.8
通讯作者：
SCHWARTZ, RS
中科院分区：
文献类型：
--
作者：
RUMBERGER, JA;SHEEDY, PF;SCHWARTZ, RS
背景 通过电子束计算机断层扫描 (EBCT) 识别的冠状动脉钙具有对冠状动脉粥样硬化疾病进行无创定位的潜力。然而，尚未在临床人群中检验患者性别对其诊断能力的影响。方法和结果 50 名女性和 89 名男性平均在冠状动脉造影后 1 天进行 EBCT 扫描。任何动脉的最大动脉造影百分比管腔直径狭窄与每个受试者的总 EBCT 冠状动脉钙评分配对。女性（年龄，56+/-11 岁 [平均值+/-SD]）比男性（年龄，47+/-7 岁）大，但受试者的动脉造影指征和动脉造影评估的疾病程度相匹配。无论动脉造影疾病的程度如何，男性和女性冠状动脉钙的敏感性、特异性以及阳性和阴性预测值几乎相同。 EBCT 对动脉造影疾病的存在高度敏感（范围为 94% 至 100%），但对显着疾病（大于或等于 50% 狭窄）仅具有中等特异性（57% 至 66%），对任何动脉造影疾病（>0% 狭窄）具有低特异性（35% 至 38%）。男性和女性对于任何动脉造影疾病的阴性预测值分别为 79% 至 91%，对于重大疾病的阴性预测值范围为 95% 至 100%。动脉造影正常的受试者和患有严重疾病的受试者之间的钙分数数值存在显着差异；然而，钙评分区分轻微中度疾病和严重疾病的能力有限。作为敏感性和特异性分析的延伸，确定的受试者工作特征曲线面积对于任何动脉造影疾病和显着动脉造影疾病的 EBCT 定义的钙评分都很高，并且在性别之间没有差异。 结论 在中年人群中，通过 EBCT 无创定义冠状动脉钙对男性和女性动脉造影冠状动脉疾病具有相似的预测价值。
Background Coronary artery calcium identified by electron beam computed tomography (EBCT) has potential for noninvasive localization of coronary atherosclerotic disease. However, the effect of a patient's sex on its diagnostic capability has not been examined in a clinical population.Methods and Results Fifty women and 89 men had EBCT scans done an average of 1 day after coronary arteriography. Maximum arteriographic percent luminal diameter stenosis of any artery was paired with the total EBCT coronary calcium score for each subject. The women (age, 56+/-11 years [mean+/-SD]) were older than the men (age, 47+/-7 years), but the subjects were matched for indications for arteriography and extent of disease as assessed by arteriography. Sensitivity, specificity, and positive and negative predictive values for coronary calcium were nearly identical for men and women, regardless of the degree of arteriographic disease. EBCT was highly sensitive to the presence of arteriographic disease (range, 94% to 100%), but had only moderate specificity (57% to 66%) for significant disease (greater than or equal to 50% stenosis) and low specificity (35% to 38%) for any arteriographic disease (>0% stenosis). Negative predictive values in men and women ranged from 79% to 91% for any arteriographic disease and from 95% to 100% for significant disease, respectively. Numerical calcium scores were significantly different between subjects with normal arteriograms and those with significant disease; however, calcium score had limited power to separate trivial moderate, and significant disease. Receiver operating characteristic curve areas, determined as an extension of the analyses of sensitivity and specificity, were high for EBCT-defined calcium scores for both any arteriographic disease and significant arteriographic disease, and were not different between the sexes.Conclusions In a middle-aged population, noninvasive definition of coronary calcium by EBCT has similar predictive value for arteriographic coronary artery disease in men and women.