冠状动脉周围脂肪参数联合临床指标预测急性冠状动脉综合征主要不良心血管事件  

Pericoronary adipose tissue parameters combined with clinical indicators for predicting major adverse cardiovascular events of acute coronary syndrome

作　　者：刘晓怡[1] 孙超[1] 程瑾[1] 綦维维[1] 洪楠[1] 王屹[1] LIU Xiaoyi;SUN Chao;CHENG Jin;QI Weiwei;HONG Nan;WANG Yi(Department of Radiology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院放射科,北京100044

出　　处：《中国医学影像技术》2023年第8期1191-1195,共5页Chinese Journal of Medical Imaging Technology

基　　金：北京大学人民医院研究与发展基金(RDJ2022-35)。

摘　　要：目的探讨冠状动脉周围脂肪组织(PCAT)脂肪衰减指数(FAI)联合临床指标预测急性冠状动脉综合征(ACS)患者发生主要不良心血管事件(MACE)的价值。方法回顾性分析186例首诊ACS患者,根据随访发生MACE与否将其分为MACE组和无MACE组。采用单因素分析和多因素logistic回归分析临床资料、实验室指标及冠状动脉CT血管造影(CCTA)所示冠状动脉主要分支左前降支(LAD)、左旋支(LCX)、右冠状动脉(RCA)狭窄程度、斑块性质及PCAT体积和FAI,筛选ACS发生MACE的独立预测因素;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价单一独立预测因素及其联合的预测效能。结果MACE组35例,无MACE组151例。RCA-FAI(OR=0.127)及高密度脂蛋白胆固醇(HDL)(OR=1.098)是ACS MACE的独立预测因素(P均<0.05)。以RCA-FAI预测ACS MACE的AUC为0.671,HDL的AUC为0.371,二者联合AUC为0.709。结论RCA-FAI联合HDL可用于预测ACS患者发生MACE。Objective To explore the predictive value of pericoronary adipose tissue(PCAT)fat attenuation index(FAI)combined with clinical indicators for predicting major adverse cardiovascular events(MACE)in patients with acute coronary syndrome(ACS).Methods Data of 186 patients with initial diagnosed ACS were retrospectively analyzed.The patients were divided into MACE group or non-MACE group according to the occurrence of MACE or not during following-up.Univariate analysis and multivariate logistic regression analysis were used to analyze clinical data,laboratory indicators,as well as stenosis degree,plaque nature,the volume and FAI of PCAT of left anterior descending artery(LAD),left circumflex artery(LCX)and right coronary artery(RCA)showed on coronary CT angiography(CCTA),and the independent predictive factors for MACE in patients with ACS were screened.Receiver operating characteristic(ROC)curves were drawn,and areas under the curve(AUC)were calculated to evaluate the predictive efficacy of independent predictive factors individually and in combination.Results There were 35 cases in MACE group and 151 cases in non-MACE group,respectively.RCA-FAI(OR=0.127)and high density lipoprotein cholesterol(HDL)(OR=1.098)were both independent predictive factors for MACE in patients with ACS(both P<0.05).AUC of RCA-FAI for predicting occurrence of MACE in patients with ACS was 0.671,of HDL was 0.371,while of their combination was 0.709.Conclusion RCA-FAI combined with HDL could predict occurrence of MACE in patients with ACS.

关 键 词：冠状动脉疾病 急性冠脉综合征 冠状血管造影术 冠状动脉周围脂肪组织 主要不良心血管事件 

分 类 号：R714.252[医药卫生—妇产科学] R814.42[医药卫生—临床医学]