Öz
Amaç: Bu çalışmanın amacı daha önce bilinen koroner arter hastalığı (KAH) tanısı olmayan olgularda
karotid arter intima-media kalınlığı ve koroner arter kalsiyum skorlamanın koroner arter BT anjiografi
incelemesi ile belirlenen koroner arter hastalığının yaygınlığını ve derecesini belirlemedeki değerlerini
karşılaştırmaktır. Materyal-Metod: Çalışmaya 64-dedektörlü çok kesitli bilgisayarlı tomografi (ÇKBT) anjiografisi çekilen
ve koroner arter kalsiyum skorlama tetkiki yapılan 184 hasta dahil edildi. Anjiografi incelemesinin ardından
7.5 MHz lineer prob kullanılarak B-mod ultrason cihazı ile tüm hastalara karotid arter intima-media kalınlığı
ölçümü yapıldı. ÇKBT anjiografi sonuçlarına göre hastalar normal, hafif KAH, orta KAH, anlamlı stenotik
KAH ve şiddetli stenotik KAH olarak sınıflandırıldı. Gruplar arasındaki carotid arter intima media kalınlığı
ve kalsiyum skoru düzeylerinde anlamlı fark olup olmadığı istatistiksel analiz ile incelendi.
Bulgular: Kalsiyum skoru ve intima-media kalınlıkları KAH olan hastalarda önemli bir artış gösterdi.
Ayrıca her ikisi de KAH öngörmede değerli bulundu. Ancak stenotik KAH'nı öngörmede intima-media
kalınlığına göre kalsiyum skorunun daha belirleyici olduğu görüldü. Karotid arter intima-media kalınlığı
değeri için stenotik KAH'nı öngörmede en iyi kesim noktası 0.88 olarak saptandı.
Sonuç: Karotid arter intima-media kalınlığı ve kalsiyum skoru KAH'nın yaygınlığını öngörmede değerlidir
ancak kalsiyum skoru intima-media kalınlığına gore KAH yaygınlığı ve şiddeti ile daha iyi korelasyon
göstermektedir. Sadece kalsiyum skoru sıfır olan hastalar değerlendirildiğinde KAH olan ve KAH olmayan
gruplar arasında ortalama intima-media kalınlıkları açısından anlamlı fark saptanmadı.
Anahtar Kelimeler
Kalsiyum skorlama intima-media kalınlığı koroner arter hastalığı koroner BTanjiografi
Kaynakça
- 1- Lester SJ, Eleid MF, Khandheria BK, Hurst RT. Carotid Intima-Media Thickness and Coronary artery Calcium Score as Indications of Subclinical Atherosclerosis. Mayo Clin Proc 2009; 84(3):229-33 2- Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97(18):1837–47 3- Conroy RM, Pyörälä K, Fitzgerald AP et al. SCORE Project group Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE Project. Eur Heart J 2003; 24(11):987–1003 4- Rumberger JA, Simons DB, Fitzpatrick LA et al. Coronary artery calcium area by electron-beam computed tomography and coronary aterosclerotic plaque area. A histopathologic correlative study. Circulation 1995; 92:2157-2162 5- O'Leary DH, Polak JF. İntima- Media Thickness: a tool for atherosclerosis imaging and event prediction. Am J Cardiol 2002; 90:18-21 6- Gaemperli O, Valenta I, Schepis T et al. Coronary 64- slice CT angiography predicts outcome in patients with known or suspected coronary artery disease. Eur Radiol 2008; 18:1162–1173 7- Santosa R D, Nasir K. Insights into atherosclerosis from invasive and non-invasive imaging studies: Should we treat subclinical atherosclerosis? Atherosclerosis 2009; 205:349-356 8- Fathi R, Marwick TH. Noninvasive tests of vascular function and structure: why and how to perform them. Am Heart J 2001; 141:694- 703 9- Terry JG, Carr JJ, Tang R et al. Coronary artery calcium outperforms carotid artery intima-media thickness as a noninvasive index of prevalent coronary artery stenosis. Arterioscler Thromb Vasc Biol 2005; 25(8):1723-8. 10- Seese B, Brandt-Pohlmann M, Moshage W, Achenbach S, Schwarz T, Bachmann K. Evaluation of the Association Between Coronary Calcification Detected by Electron Beam Computed Tomography and Atherosclerosis of Extracranial Carotid Arteries In Vivo. Int J Angiol 1998; 7(4):301-6 11- Burke GL, Evans GW, Riley WA et al. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adult The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 1995; 26:386-391 12- Salonen JT, Salonen R. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb 1991; 11:1245-1249 13- Chambless LE, Folsom AR, Davis V et al. Risk factors for progression of common carotid atherosclerosis: the Atherosclerosis Risk in Communities Study, 1987-1998. Am J Epidemiol 2002; 155:38-47 14- Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 1993; 87( SupplII):56-65 15- Coskun U, Yıldız A, Esen O.B. Relationship between carotid intima-media thickness and coronary angiographic findings:a prospective study. Cardiovascular Ultrasound 2009; 7:59 16- Adams MR, Nakagomi A, Keech Aet al. Carotid intimamedia thickness is only weakly correlated with the extent and severity of coronary artery disease. Circulation 1995; 92: 2127-34 17- Newman AB, Naydeck BL, Ives DG et al. Coronary artery calcium, carotid artery wall thickness and cardiovascular disease outcomes in adults 70 to 99 years old. Am J Cardol 2008; 101(2):186-192 18- Folsom AR, Kronmal RA, Detrano RC et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 2008; 168:1333–1339
Öz
Background: The aim of this study is to compare the values of carotid artery intima-media thickness (CIMT)
and coronary artery calcium scoring (CACS) in determining extention and severity of coronary artery
disease (CAD) that diagnosed via coronary CT angiography in patients without known diagnosis of CAD
previously.
Methods: 184 patients were included in the study. All patients were undergone CACS examination with 64-
detector MDCTscanner for coronary angiography examination. Following angiography examination, CIMT
was measured for all patients using B-mode ultrasound device with a 7.5 MHz linear probe. According to the
results of coronary CT angiography, patients were classified as normal, mild CAD, moderate CAD,
significant stenotic CAD, severely stenotic CAD. The significant difference of calcium score and CIMT
levels between these groups was examined with statistical analysis.
Results: Calcium score and CIMT showed significant increase in patients with CAD. They were also found
valuable in predicting stenotic CAD, however CACS was found to be more decisive than CIMT for
prediction of stenotic CAD. The best cut-off point for CIMTto predict stenotic CAD was 0.88mm.
Conclusion: CACS and CIMT measurements are valuable in determining extention of CAD, however
CACS has a better correlation with extention and severity of CAD compared with CIMT. When we evaluated
the patients with zero calcium score alone, we found no significant difference in terms of the average CIMT
between the group of existing CAD, and the group of non-existing CAD
Anahtar Kelimeler
Calcium score intima-media thickness coronary artery disease coronary CTangiography
Kaynakça
- 1- Lester SJ, Eleid MF, Khandheria BK, Hurst RT. Carotid Intima-Media Thickness and Coronary artery Calcium Score as Indications of Subclinical Atherosclerosis. Mayo Clin Proc 2009; 84(3):229-33 2- Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97(18):1837–47 3- Conroy RM, Pyörälä K, Fitzgerald AP et al. SCORE Project group Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE Project. Eur Heart J 2003; 24(11):987–1003 4- Rumberger JA, Simons DB, Fitzpatrick LA et al. Coronary artery calcium area by electron-beam computed tomography and coronary aterosclerotic plaque area. A histopathologic correlative study. Circulation 1995; 92:2157-2162 5- O'Leary DH, Polak JF. İntima- Media Thickness: a tool for atherosclerosis imaging and event prediction. Am J Cardiol 2002; 90:18-21 6- Gaemperli O, Valenta I, Schepis T et al. Coronary 64- slice CT angiography predicts outcome in patients with known or suspected coronary artery disease. Eur Radiol 2008; 18:1162–1173 7- Santosa R D, Nasir K. Insights into atherosclerosis from invasive and non-invasive imaging studies: Should we treat subclinical atherosclerosis? Atherosclerosis 2009; 205:349-356 8- Fathi R, Marwick TH. Noninvasive tests of vascular function and structure: why and how to perform them. Am Heart J 2001; 141:694- 703 9- Terry JG, Carr JJ, Tang R et al. Coronary artery calcium outperforms carotid artery intima-media thickness as a noninvasive index of prevalent coronary artery stenosis. Arterioscler Thromb Vasc Biol 2005; 25(8):1723-8. 10- Seese B, Brandt-Pohlmann M, Moshage W, Achenbach S, Schwarz T, Bachmann K. Evaluation of the Association Between Coronary Calcification Detected by Electron Beam Computed Tomography and Atherosclerosis of Extracranial Carotid Arteries In Vivo. Int J Angiol 1998; 7(4):301-6 11- Burke GL, Evans GW, Riley WA et al. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adult The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 1995; 26:386-391 12- Salonen JT, Salonen R. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb 1991; 11:1245-1249 13- Chambless LE, Folsom AR, Davis V et al. Risk factors for progression of common carotid atherosclerosis: the Atherosclerosis Risk in Communities Study, 1987-1998. Am J Epidemiol 2002; 155:38-47 14- Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 1993; 87( SupplII):56-65 15- Coskun U, Yıldız A, Esen O.B. Relationship between carotid intima-media thickness and coronary angiographic findings:a prospective study. Cardiovascular Ultrasound 2009; 7:59 16- Adams MR, Nakagomi A, Keech Aet al. Carotid intimamedia thickness is only weakly correlated with the extent and severity of coronary artery disease. Circulation 1995; 92: 2127-34 17- Newman AB, Naydeck BL, Ives DG et al. Coronary artery calcium, carotid artery wall thickness and cardiovascular disease outcomes in adults 70 to 99 years old. Am J Cardol 2008; 101(2):186-192 18- Folsom AR, Kronmal RA, Detrano RC et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 2008; 168:1333–1339
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Ağustos 2015 |
| Gönderilme Tarihi | 19 Şubat 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 12 Sayı: 2 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty