冠脉CT血管造影对冠心病患者MACE的预测价值  

Predictive value of coronary CT angiography for MACE in patients with coronary heart disease

作　　者：王晶[1] 王全帮 杨艳[1] 季鹏[1] WANG Jing;WANG Quan-bang;YANG Yan;JI Peng(Imaging Center,Third People's Hospital of Hefei City,Hefei,Anhui,230022,China)

机构地区：[1]合肥市第三人民医院影像中心,安徽合肥230022

出　　处：《心血管康复医学杂志》2022年第4期418-423,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究冠脉CT血管造影(CCTA)对冠心病主要不良心血管事件(MACE)的预测价值。方法:依据随访中是否发生MACE,于我院行CCTA检查且完成随访24个月的115例冠心病患者被分为MACE组(35例)和无MACE组(80例)。使用倾向性得分配对法(PSM)对MACE组和无MACE组进行1∶1匹配,分析CCTA对MACE的预测价值。结果:PSM成功匹配33对。匹配后,与无MACE组比较,MACE组易损斑块比例、冠脉狭窄程度均显著升高,冠脉CT血流储备分数(CT-FFR)均显著降低(P<0.05或<0.01)。非条件二分类Logistic回归分析结果显示,易损斑块、冠脉狭窄程度是冠心病患者发生MACE的独立危险因素(OR=3.190、6.285,P均<0.05),CT-FFR是其独立保护因素(OR=0.118,P=0.035)。ROC曲线分析显示,CT-FFR、冠脉狭窄程度及二者联合预测冠心病患者发生MACE的曲线下面积分别为0.794、0.793、0.916,灵敏度分别为84.8%、63.6%、81.8%,特异度分别为69.7%、84.8%、90.9%。结论:冠脉狭窄程度、易损斑块是冠心病患者MACE发生的独立危险因素,CT-FFR是MACE发生的独立保护因素,CT-FFR联合冠脉狭窄程度对MACE具最高预测价值。Objective:To study predictive value of coronary computed tomography angiography(CCTA)for major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD).Methods:According to whether MACE occurred during follow-up,a total of 115 CHD patients undergoing CCTA in our hospital and completing 24-month follow-up were divided into MACE group(n=35)and no-MACE group(n=80).MACE and no-MACE groups were 1:1 matched using propensity scoring matching method(PSM).Predictive value of CCTA for MACE were analyzed.Results:A total of 33 pairs were successfully matched by PSM.After matching,compared with no-MACE group,there were significant rise in percentage of vulnerable plaques and severity of coronary stenosis,and significant reduction in coronary CT fractional flow reserve(CT-FFR)in MACE group(P<0.05 or<0.01).Unconditional binary Logistic regression analysis indicated that vulnerable plaque and severity of coronary stenosis were independent risk factors for MACE in CHD patients(OR=3.190,6.285,P<0.05 both),and CT-FFR was its independent protective factor(OR=0.118,P=0.035).ROC curve analysis indicated that areas under curve(AUC)of CT-FFR,severity of coronary stenosis and combined detection for predicting MACE in CHD patients was 0.794,0.793 and 0.916 respectively,sensitivities was 84.8%,63.6% and 81.8% respectively;specificities was 69.7%,84.8% and 90.9% respectively.Conclusion:Severity of coronary stenosis and vulnerable plaque are independent risk factors for MACE in CHD patients,and CT-FFR is its independent protective factor.CT-FFR combined severity of coronary stenosis possesses highest predictive value for MACE.

关 键 词：冠心病 冠脉血管造影术 危险因素 

分 类 号：R541.409[医药卫生—心血管疾病]