経皮的冠動脈インターベンションを必要とする虚血性心疾患患者の冠動脈責任病変プラーク面積を規定する因子の検討
【目的】冠動脈プラークの増加は心血管イベント発症のリスクとされている．本研究の目的は経皮的冠動脈インターベンションを必要とする虚血性心疾患患者において血管内超音波法で計測された冠動脈責任病変プラーク面積を規定する因子を明らかにすることである．【方法】当院にて経皮的冠動脈インターベンションを施行した虚血性心疾患患者連続304名(急性冠症候群206名)を対象とした．責任冠動脈病変の最も内腔面積が小さな最小血管内腔部位におけるプラーク面積を従属変数として，年齢，性別，急性冠症候群，高血圧，糖尿病，脂質異常症，喫煙，アンジオテンシン変換酵素阻害薬／アンジオテンシンII受容体拮抗薬内服，スタチン内服，H...
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| Published in | 日本冠疾患学会雑誌 Vol. 18; no. 1; pp. 21 - 29 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本冠疾患学会
25.02.2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1341-7703 2187-1949 |
| DOI | 10.7793/jcoron.18.478 |
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| Abstract | 【目的】冠動脈プラークの増加は心血管イベント発症のリスクとされている．本研究の目的は経皮的冠動脈インターベンションを必要とする虚血性心疾患患者において血管内超音波法で計測された冠動脈責任病変プラーク面積を規定する因子を明らかにすることである．【方法】当院にて経皮的冠動脈インターベンションを施行した虚血性心疾患患者連続304名(急性冠症候群206名)を対象とした．責任冠動脈病変の最も内腔面積が小さな最小血管内腔部位におけるプラーク面積を従属変数として，年齢，性別，急性冠症候群，高血圧，糖尿病，脂質異常症，喫煙，アンジオテンシン変換酵素阻害薬／アンジオテンシンII受容体拮抗薬内服，スタチン内服，HbA1c，LDLコレステロール(low density lipoprotein cholesterol; LDL-C)，HDLコレステロール(high density lipoprotein cholesterol; HDL-C)，LDL-C/HDL-C比，病変の偏心性(エクセントリシティ・インデックス; EI)，カルシウム角度，リモデリング・インデックス(RI)を独立変数とした単回帰分析を実施したのち、多重共線性のある独立変数を除いて重回帰分析を行った．【結果】単回帰分析において高血圧，糖尿病，脂質異常症，喫煙，アンジオテンシン変換酵素阻害薬／アンジオテンシンII受容体拮抗薬内服，スタチン内服，HbA1c，LDL-Cはプラーク面積と相関を示さなかったが，性別(p=0.006)，急性冠症候群(p=0.005)，LDL-C/HDL-C比(p=0.012)，RI(p<0.001)が正の相関，年齢(p=0.025)，HDL-C(p=0.001)，EI(p=0.003)カルシウム角度(p=0.029)は有意な負の相関を示した．重回帰分析を行ったところ，HDL-C(p=0.025)とEI(p=0.020)がプラーク面積の独立した負の規定因子であった．【結論】経皮的冠動脈インターベンションを必要とする虚血性心疾患患者において，冠動脈責任部位におけるプラーク面積を規定したものはHDLコレステロールと病変の偏心性であった． |
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| AbstractList | 【目的】冠動脈プラークの増加は心血管イベント発症のリスクとされている．本研究の目的は経皮的冠動脈インターベンションを必要とする虚血性心疾患患者において血管内超音波法で計測された冠動脈責任病変プラーク面積を規定する因子を明らかにすることである．【方法】当院にて経皮的冠動脈インターベンションを施行した虚血性心疾患患者連続304名(急性冠症候群206名)を対象とした．責任冠動脈病変の最も内腔面積が小さな最小血管内腔部位におけるプラーク面積を従属変数として，年齢，性別，急性冠症候群，高血圧，糖尿病，脂質異常症，喫煙，アンジオテンシン変換酵素阻害薬／アンジオテンシンII受容体拮抗薬内服，スタチン内服，HbA1c，LDLコレステロール(low density lipoprotein cholesterol; LDL-C)，HDLコレステロール(high density lipoprotein cholesterol; HDL-C)，LDL-C/HDL-C比，病変の偏心性(エクセントリシティ・インデックス; EI)，カルシウム角度，リモデリング・インデックス(RI)を独立変数とした単回帰分析を実施したのち、多重共線性のある独立変数を除いて重回帰分析を行った．【結果】単回帰分析において高血圧，糖尿病，脂質異常症，喫煙，アンジオテンシン変換酵素阻害薬／アンジオテンシンII受容体拮抗薬内服，スタチン内服，HbA1c，LDL-Cはプラーク面積と相関を示さなかったが，性別(p=0.006)，急性冠症候群(p=0.005)，LDL-C/HDL-C比(p=0.012)，RI(p<0.001)が正の相関，年齢(p=0.025)，HDL-C(p=0.001)，EI(p=0.003)カルシウム角度(p=0.029)は有意な負の相関を示した．重回帰分析を行ったところ，HDL-C(p=0.025)とEI(p=0.020)がプラーク面積の独立した負の規定因子であった．【結論】経皮的冠動脈インターベンションを必要とする虚血性心疾患患者において，冠動脈責任部位におけるプラーク面積を規定したものはHDLコレステロールと病変の偏心性であった． |
| Author | 西岡, 利彦 塚田, 俊一 吉本, 信雄 佐々木, 修 |
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| ContentType | Journal Article |
| Copyright | 2012 日本冠疾患学会 |
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| Snippet | 【目的】冠動脈プラークの増加は心血管イベント発症のリスクとされている．本研究の目的は経皮的冠動脈インターベンションを必要とする虚血性心疾患患者において血管内超音... |
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| SubjectTerms | HDL cholesterol LDL cholesterol plaque area |
| Title | 経皮的冠動脈インターベンションを必要とする虚血性心疾患患者の冠動脈責任病変プラーク面積を規定する因子の検討 |
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| ispartofPNX | 日本冠疾患学会雑誌, 2012/02/25, Vol.18(1), pp.21-29 |
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