钙化积分与冠状动脉多支病变介入术后预后的相关性

目的 研究冠状动脉钙化积分（CCS）与冠状动脉多支血管病变患者经皮冠状动脉介入治疗（PCI）后近、远期预后的关系.方法 入选145例冠状动脉多支血管病变的冠心病患者,在PCI治疗前均接受了多排螺旋CT （MDCT）检查并计算CCS.根据CCS水平将患者分为三组：CCS≤100、CCS=101～400和CCS＞400组.记录患者PCI操作相关并发症,随访记录患者PCI术后主要不良心血管事件（MACE）情况.结果 CCS＞400组患者Syntax积分[（23.5＆#177;8.8）比（17.9＆#177;8.5）,P＜0.001]、三支血管病变的比率（75.4％比56.3％,P=0.015）和PCI操作相关并发症发生率（21.5％比5.0％,P=0.005）均显著高于CCS≤400组患者.所有患者随访360～2542 d（中位数952 d）,Kaplan-Meier生存分析显示CCS≤100、CCS=101～400和CCS＞400组患者累积无事件生存率差异无统计学意义（84.6％比78.0％比64.6％,P=0.141）.但女性患者中累积无事件生存率差异有统计学意义（100.0％比75.0％比50.0％,Log rank 6.836,P=0.033）.结论 在冠状动脉多支血管病变患者中CCS与PCI预后有关,CCS＞400提示较高的PCI并发症发生率.女性患者CCS越高PCI预后越差.

Association between coronary artery calcium score and prognosis in patients with multi-vessel disease underwent percutaneous coronary intervention

Objective The aim of the study is to investigate the association between coronary artery calcium score （CCS） and prognosis in patients with multi-vessel disease undergoing percutaneous coronary intervention （PCI）. Methods 145 consecutive patients with coronary artery disease and coronary angiographic multi-vessel disease were enrolled. All patients underwent first coronary angiography and PCI within 3 months after multi-detector computed tomography （MDCT）. CCS was calculated. The patients were divided into 3 groups： CCS ≤ 100, 101 to 400 and 〉 400 according to guidelines. Procedure-related complications and main adverse cardiac events were recorded. Results Compare to the patients with CCS 400, the Syntax score [-（17.9±8.5） vs. （23.5±8.8）, P 〈 0.001 ] , the proportion of three-vessel disease （56.3% vs. 75.4%, P=0.015） and PCI complications （5.0% vs. 21.5%, P=0.005） were higher in patients with CCS 〉400. All patients were followed up （median 952 days, range 360 to 2542 days）. Kaplan-Meier survival analysis showed that patients with CCS ≤100, 101 to 400 and 〉 400 had similar cumulativenon-events survival rates （84.6% vs. 78.0% vs. 64.6%, P=-0.141）. However, it showed significant different cumulative non-events survival rates in female subgroup （100.0% vs. 75.0% vs. 50.0%, Log rank 6.836, P=-0.033）. Conclusions CCS assessed by MDCT associated with prognosis in patients with multi-vessel disease underwent PCI. CCS 〉 400 indicates high PCI complications, and higher CCS indicates poorer prognosis in female subgroup.