冠状动脉钙化积分评估经皮冠状动脉介入治疗术后稳定型心绞痛患者预后

Coronary artery calcium score in prognostic assessment of stable angina patients with percutaneous coronary intervention

目的评价冠状动脉钙化(CAC)积分在经皮冠状动脉介入治疗(PCI)术后稳定型心绞痛(SAP)患者预后的价值。方法对400例PCI术后SAP患者行MSCT检查,CAC积分根据标准Agatston钙化计分方法。根据CAC积分分为低CAC积分组(CAC积分≤300)235例,高CAC积分组(CAC积分>300)165例,分析CAC积分与临床特征、手术并发症、重大不良事件(MACE)的关系。结果 CAC积分与年龄(r=0.34,P<0.001)、收缩压(r=0.20,P=0.020)正相关;单因素分析显示,高CAC积分组手术并发症发生率比低CAC积分组增加4.62倍(P=0.020),经年龄、糖尿病史、多支血管病变校正后,CAC积分仍是手术并发症的独立危险因素(OR=4.56,P=0.033);Kaplan-Meier生存分析显示,低CAC积分组、高CAC积分组累积无事件生存率分别为88.94%和77.58%,差异有统计学意义(P=0.038)。结论 CAC积分是PCI术后SAP患者发生MACE的独立预测因素,与手术发症有关。

Objective To explore the prognostic value of coronary artery calcium （CAC） score in stable angina patients with percutaneous coronary intervention （PCI）. Methods A total 400 patients of stable angina pectoris who underwent percutaneous coronary intervention following multi-slice computer tomography were enrolled. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. According to the CAC was divided into low CAC integral group （CAC score ≤300, n=235） and high CAC score group （CAC score〉300, n=165）. Relationship between CAC score and characteristics, surgical complications, major adverse events （MACE） were analyzed. Results The CAC score with age （r=0.34, P〈0.001）, systolic blood pressure（r=0.20, P=0.200） was positive correlation. Compared to low CAC integral score group, surgical complication rate in high CAC score group was increased 4.62 times （P=0.020）, After adjusted for other factors, the risk of surgical complication was significantly higher （OR=4.56, P=0.033）. The Kaplan-Meier survival analysis showed that accumulation event free survival rates were 88.94% and 77.58% in lower CAC group and higher CAC group respectively, difference was statistically significant （P=0.038）. Conclusion The CAC score is an independent predictor for main adverse cardiac events in SAP patients who underwent PCI and procedure-related complications.