冠脉CT血管成像评估冠脉CTO患者PCI术后预后的价值

Value of Coronary Computed Tomography Angiography in the Evaluation of Prognosis of Patients with Coronary Artery CTO after PCI

目的探讨冠脉CT血管成像(CCTA)评估冠脉慢性完全闭塞病变(CTO)患者经皮冠脉介入(PCI)术后预后的价值。方法选取2017年12月至2019年12月我院收治的200例冠脉CTO患者,根据患者手术情况分为失败组和成功组。分析影响冠脉CTO患者PCI术后预后的因素,以及J-CTO、CT-RECTOR积分预测患者预后的价值。结果单因素及Logistic多因素分析结果显示,负性重构、血管弯曲、闭塞形态、钙化程度与冠脉CTO患者PCI失败密切相关(P<0.05)。J-CTO、CT-RECTOR积分预测冠脉CTO患者PCI失败的AUC为0.785、0.869。结论CCTA参数负性重构、血管弯曲>45°、钝形闭塞、钙化程度>50%与冠脉CTO患者PCI失败密切相关,术前进行CCTA检查有助于预测PCI手术结果。

Objective To explore the value of coronary computed tomography angiography(CCTA)in the evaluation of prognosis of patients with coronary chronic total occlusion(CTO)after percutaneous coronary intervention(PCI).Methods 200 patients with coronary CTO admitted to our hospital from December 2017 to December 2019 were selected and divided into failure group and success group according to the operation conditions.The factors affecting the prognosis of patients with coronary CTO after PCI were analyzed,and the value of J-CTO and CT-RECTOR scores predicting the prognosis of patients were analyzed.Results Univariate and logistic multivariate analysis showed that negative remodeling,vascular curvature,occlusion morphology and calcification degree were closely correlated with PCI failure of patients with coronary CTO(P<0.05).The AUC of J-CTO and CT-RECTOR score predicting PCI failure in patients with coronary CTO were 0.785 and 0.869.Conclusions Negative remodeling,vessel curvature>45°,obtuse occlusion and calcification degree>50%are closely correlated with PCI failure of patients with coronary CTO.Preoperative CCTA is helpful to predict the PCI results.