首页|冠状动脉CT血管成像斑块纹理参数对初诊冠心病患者主要不良心血管事件的预测价值分析

冠状动脉CT血管成像斑块纹理参数对初诊冠心病患者主要不良心血管事件的预测价值分析

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目的:分析冠状动脉CT血管成像(CCTA)斑块纹理参数对初诊冠心病患者主要不良心血管事件(MACE)的预测价值.方法:选择 2022 年 2 月—2023 年 8 月中国人民解放军联勤保障部队庐山康复疗养中心收治的 116 例初诊冠心病患者,以是否发生MACE为依据,将患者分为MACE发生组(n=37)和MACE非发生组(n=79).依次为患者进行CCTA,比较两组的斑块纹理参数及既往用药史.进行多因素logistic回归分析,绘制通受试者操作特征(ROC)曲线,分析斑块纹理参数预测初诊冠心病患者MACE的准确性.结果:在本次 116 例初诊冠心病患者中共有 37 例患者发生MACE,其中有 17 例为血运重建的不稳定性心绞痛,占比为 45.95%.两组对比度、峰度、偏度及既往用药史比较,差异均无统计学意义(P>0.05);MACE发生组熵、方差高于MACE非发生组,而角二阶矩、平均值低于MACE非发生组,差异均有统计学意义(P<0.05).logistic回归分析显示,熵、方差为初诊冠心病患者发生MACE的危险因素,而角二阶矩为初诊冠心病患者发生MACE的保护因素(P<0.05).ROC曲线分析显示,方差和熵预测初诊冠心病患者发生MACE的AUC分为 0.882、0.789,角二阶矩预测初诊冠心病患者发生MACE的AUC为 0.287.结论:CCTA斑块纹理参数在初诊冠心病患者MACE的预测中具有较高的诊断效能.
Analysis of the Predictive Value of Coronary Artery CT Vascular Imaging Plaque Texture Parameters for Major Adverse Cardiac Events in Newly Diagnosed Coronary Heart Disease Patients
Objective:To analyze the predictive value of coronary artery CT angiography(CCTA)plaque texture parameters for major adverse cardiac events(MACE)in newly diagnosed coronary heart disease patients.Method:A total of 116 newly diagnosed coronary heart disease patients admitted to Lushan Rehabilitation and Recuperation Center of Chinese People's Liberation Army Joint Logistic Support Force from February 2022 to August 2023 were selected and divided into MACE occurrence group(n=37)and non-MACE occurrence group(n=79).CCTA was performed on the patients successively,and the plaque texture parameters and previous medication history of the two groups were compared.Multivariate logistic regression analysis was performed,receiver operating characteristic(ROC)curve was drawn,and the accuracy of plaque texture parameters in predicting MACE in newly diagnosed coronary heart disease patients was analyzed.Result:Among the 116 newly diagnosed coronary heart disease patients,a total of 37 patients had MACE,of which 17 were unstable angina pectoris due to revascularization,accounting for 45.95%.There were no significant differences in contrast,kurtosis,skewness and previous medication history between the two groups(P>0.05).The entropy and variance of the MACE occurrence group were higher than those of the non-MACE occurrence group,while the angular second order moment and mean value were lower than those of the non-MACE occurrence group,the differences were statistically significant(P<0.05).logistic regression analysis showed that entropy and variance were the risk factors for MACE in newly diagnosed coronary heart disease patients,while angular second moment was the protective factor for MACE in newly diagnosed coronary heart disease patients(P<0.05).ROC curve analysis showed that the AUC of variance and entropy to predict MACE in newly diagnosed coronary heart disease patients was 0.882 and 0.789,and the AUC of angular second order moment to predict MACE in newly diagnosed coronary heart disease patients was 0.287.Conclusion:CCTA plaque texture parameters have high diagnostic efficacy in the prediction of MACE in newly diagnosed coronary heart disease patients.

Coronary artery CT angiographyPlaque texture parametersCoronary heart diseaseCardiovascular adverse events

于长栋、胡蝶、周炀、汪明、高文

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中国人民解放军联勤保障部队庐山康复疗养中心放射科 江西 九江 332000

九江学院第二附属医院心血管内科 江西 九江 332000

九江市中医医院放射科 江西 九江 332000

冠状动脉CT血管成像 斑块纹理参数 冠心病 心血管不良事件

江西省卫生健康普通科技计划项目

202211392

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(22)