Radiology:冠脉周围脂肪沉积是急性斑块破裂及冠状动脉夹层的标识物

2018-04-06 shaosai MedSci原创

本研究旨在评价怀疑急性冠脉综合征(ACS)患者冠状动脉CTA上血管周围脂肪沉积的发生率及影响,并将结果发表在Radiology上。

本研究旨在评价怀疑急性冠脉综合征(ACS)患者冠状动脉CTA上血管周围脂肪沉积的发生率及影响,并将结果发表在Radiology上。

研究人员回顾性分析了1403例行冠脉CTA的患者图像(796例男性,平均年龄为52.8岁)。评价受累节段和未受累心外膜血管的圆周象限的脂肪密度、数量及长度CT值。纳入病例为血管周围有脂肪沉积的患者。将有重度狭窄而无脂肪沉积的患者作为对照组。利用两样本T检验、Mann-Whitney U和Fisher检验比较病例组和对照组的基线影像学特征、ACS发生频率和随后的测试。

结果为,共有11例患者出现血管周围脂肪沉积,9例为动脉粥样硬化和2例为急性冠脉夹层,平均脂肪沉积长度为19.2,平均象限为2.9个。血管周围沉积脂肪、正常心外膜脂肪和皮下脂肪的平均密度分别为17、-93.2、-109.3 HU, (P < .001)。在病例组和对照组间,Agatston 评分、室壁运动异常和血清肌钙蛋白水平具有显着性差异(P < .05)。在病例组和对照组发生ACS的频率分别为45.4%、3.8% (P = .001)。

本研究表明,血管周围脂肪沉积的识别可能有助于预测有冠脉严重狭窄或急性冠脉夹层的责任病变,并作为ACS风险的预测指标。

原始出处:


10.1148/radiol.2017171568

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    2018-04-07 虈亣靌

    学习了.谢谢作者分享!

    0

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    2018-04-06 清风拂面

    谢谢分享学习

    0

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JAMA:PCI围术期患者需要应用负荷剂量他汀吗?从ARMYDA-ACS到ALPACS与ISCAP,再到SECURE-PCI

2018年ACC年会正在进行中。除了ODYSSEY OUTCOMES研究外,本届年会最受关注的另一个热点当属SECURE-PCI研究(Statins Evaluation in Coronary Procedures and Revascularization Trial)。

Lancet:双抗血小板治疗缩短至6个月导致PCI患者心肌梗死风险增加

研究认为对于急性冠脉综合征患者在支架植入后接受6个月的双抗血小板治疗与现行12个月的治疗威廉亚洲博彩公司 相比,会导致患者心肌梗死和支架血栓风险增加。对于出血风险低的患者,至少12个月的双抗血小板治疗是必要的

Intern Med J:急性冠脉综合征的抗血小板治疗:氯吡格雷vs替格瑞洛

2017年11月,发表在《Intern Med J》的一项由新西兰科学家进行的研究考察了急性冠脉综合征的抗血小板治疗:氯吡格雷和替格瑞洛的结局和停药之间的差异。

Heart:看国外急性冠脉综合征的管理特点和结果!

斯里兰卡的缺血性心脏病是院内死亡率的主要原因。斯里兰卡急性冠脉综合征审计项目(ACSSLAP)是第一个评估国有医院的临床审计项目,其评估了患者特征、临床结果和国家提供的护理。近期,一项发表在杂志HEART上的ACSSLAP前瞻性地评估了所有管理ACS患者的国有医院提供的急诊护理、院内护理和出院计划。数据收集来自每个医院在2-4周时间内的连续30名患者。审计标准使用当地和国际建议。此项研究结果显示:

Lancet:多学科讨论:急性冠脉综合征患者PCI后降阶梯治疗不输标准治疗

2017年10月,发表在《Lancet》的一项由德国、匈牙利、波兰和奥地利科学家进行的随机、开放式标签的多中心试验(TROPICAL-ACS),考察了相比于标准普拉格雷治疗,指导降阶梯抗血小板治疗对经皮冠状动脉介入(PCI)治疗的急性冠状动脉综合征(ACS)患者的有效性和安全性。

Circulation:ACS后疾病稳定的患者:将依折麦布添加到辛伐他汀有“惊喜”

急性冠脉综合征(ACS)患者动脉粥样硬化血栓形成事件的风险增加。这些事件不局限于冠脉血管,也包括缺血性卒中——因长期失能风险而最令人恐惧的心血管事件。2017年12月,发表在《Circulation》的IMPROVE-IT(结局降低的改善:Vytorin有效性国际试验)试验,考察了依折麦布+他汀中预防ACS患者卒中的疗效。