無冠狀動脈症狀的中老年人心血管風險因子之探討：以東部某醫學中心為例

Cardiovascular Risk Factors for Middle-aged and Older Adults without Coronary Artery Symptoms

陳立國(Li-Guo Chen) ； 黃麗娟(Li-Chuan Huang) ； 許明輝(Min-Huei Sheu) ； 杜興洋(Hsing-Yang Tu) ； 吳彬安(Ping-An Wu)

《臺灣醫事放射期刊》 7卷2期 (2019/12) Pp. 1-6

https://doi.org/10.6717/JTMRT.201912_7(2).0001

摘要

本研究探討中老年人無冠狀動脈症狀者之心血管風險因子（CVRFs）與冠狀動脈狹窄程度及冠狀動脈鈣化分數之間的相關性。共收集312位無冠狀動脈症狀的受檢者［男：114；女：198，平均年齡49.5 ± 6.1（40-70）歲］，接受冠狀動脈電腦斷層檢查及冠狀動脈鈣化檢查的影像資料進行分析，依冠狀動脈鈣化分數將受檢者分為有及無冠狀動脈鈣化兩組，評估其心血管風險因子（BMI, age, sex, GLU-AC, TCH及LDL-C）及產生冠狀動脈鈣化與冠狀動脈狹窄程度風險之相關性。使用單變量邏輯斯迴歸分析冠狀動脈鈣化分數與CVRFs之勝算比。兩組的受檢者相比勝算比大於1的項目如下：（1）BMI≥30 kg/m^2（OR：2.1, 95% CI：1.0- 4.2，p ＜ 0.05）；（2）年齡＞50歲（OR：2.5, 95%，CI：1.5-4.1，p ＜0.001）；（3）男（OR：5.7, 95%，CI：3.3-9.9，p ＜ 0.001）；（4）GLU-AC gm/dL（OR：2.0, 95%，CI：1.1-3.5，p ＜ 0.001）；（5）TCH mg/dL（OR：1.4, 95%，CI：0.9-2.4，p ＜ 0.001）；（6）LDL-C mg/dL（OR：1.8, 95%，CI：1.0-3.0，p ＜ 0.001）。依結果顯示，有CVRFs的中老年人有較高的冠狀動脈鈣化的風險，且BMI越高其冠狀動脈鈣化與冠狀動脈狹窄嚴重程度越高。

關鍵字

冠狀動脈鈣化分數 ； 身體質量指數 ； 冠狀動脈電腦斷層 ； 勝算比 ； 心血管風險因子

並列摘要

This study investigated the relevancy among cardiovascular risk factors (CVRFs) and coronary artery stenosis and coronary calcification scores in middle- and-older-aged subjects without coronary artery disease (CAD). A total of 312 subjects without CAD were recruited (male: 114; female: 198; mean age 49.51 ± 6.1 (40-70) years old. They underwent coronary computed tomography and coronary artery calcification examination. The coronary artery calcification scores divided them into two groups, depending on whether they suffer from coronary artery calcification or not. We assessed association among CVRFs (BMI, age, sex, GLU-AC, TCH, and LDL-C) and the risk of coronary artery calcification and coronary artery stenosis. Univariate logistic regression was used to analyze the odds ratio (OR) of coronary artery calcification and CVRFs. The items in which subjects with the OR greater than 1 in the two groups are as follows (1) BMI ≥ 30 kg/m^2 (OR: 2.1, 95% CI: 1.0- 4.2, p ＜ 0.05); (2) Age ＞ 50 years (OR: 2.5, 95% CI: 1.5-4.1, p ＜ 0.001); (3) Male (OR: 5.7, 95% CI: 3.3-9.9, p ＜ 0.001); (4) GLU-AC gm/dL (OR: 2.0, 95% CI: 1.1-3.5, p ＜ 0.001); (5) TCH mg/dL (OR: 1.4, 95% CI: 0.9-2.4, p ＜ 0.001); (6) LDL-C mg/dL (OR: 1.8, 95% CI: 1.0-3.0, p ＜ 0.001). As a result, subjects with high CVRFs OR value have a higher risk of coronary artery calcification. Higher BMI can lead to higher risk of coronary artery calcification and higher severity of coronary stenosis.

並列關鍵字

Coronary Artery Calcium Score, CACS ； Body Mass Index, BMI ； Coronary Computed Tomography Angiography, CCTA ； Odds ratio, OR ； Cardiovascular Risk Factors, CVRFs