CAJ | 학술논문

目的：探讨冠状动脉CT成像显示为轻度狭窄（狭窄程度25%~50%）的急性胸痛低危患者的短期预后以明确其是否需要进一步行诊断性检查。方法纳入2008年3月~2012年2月邯郸市中心医院心肌梗死溶栓（TIMI）危险评分为低危、冠状动脉CT成像显示为轻度狭窄的急性胸痛患者215例。通过观察患者30天内的主要不良心血管事件（心肌梗死、不稳定心绞痛、冠状动脉血运重建和心血管死亡），以明确行进一步诊断检查的必要性。结果30 d随访期间，仅1例患者（0.5%）发生了主要不良心血管事件（95%CI：0%~2.6%），该患者在住院期间第3次复查肌钙蛋白T时呈阳性结果。无患者发生心血管死亡或需要血运重建。结论冠状动脉CT成像显示为轻度狭窄的急性胸痛患者近期发生主要不良心血管事件的可能性非常低，对此类患者行系列心脏生物学标志物检查有可能获益，但无需行进一步诊断检查。
목적：탐토관상동맥CT성상현시위경도협착（협착정도25%~50%）적급성흉통저위환자적단기예후이명학기시부수요진일보행진단성검사。방법납입2008년3월~2012년2월함단시중심의원심기경사용전（TIMI）위험평분위저위、관상동맥CT성상현시위경도협착적급성흉통환자215례。통과관찰환자30천내적주요불양심혈관사건（심기경사、불은정심교통、관상동맥혈운중건화심혈관사망），이명학행진일보진단검사적필요성。결과30 d수방기간，부1례환자（0.5%）발생료주요불양심혈관사건（95%CI：0%~2.6%），해환자재주원기간제3차복사기개단백T시정양성결과。무환자발생심혈관사망혹수요혈운중건。결론관상동맥CT성상현시위경도협착적급성흉통환자근기발생주요불양심혈관사건적가능성비상저，대차류환자행계렬심장생물학표지물검사유가능획익，단무수행진일보진단검사。
Objective To investigate the short-term prognosis of mild coronary stenosis (25%-50%) diagnosed by coronary computerized tomography (CT) in the patients with acute chest pain, and determine if they need further diagnostic examinations. Methods The patients (n=215) with lower risk TIMI scores and mild coronary stenosis diagnosed by coronary CT were chosen from Handan Central Hospital from Mar. 2008 to Feb. 2012. The necessity of further diagnostic examinations was determined through observing the incidence of major adverse cardiovascular events (MACE) within 30 days including myocardial infarction, unstable angina, coronary revascularization and cardiovascular death. Results During 30-dya follow-up period, there was only one patients (0.5%) with MACE (95%CI:0%~2.6%), who had positive results of cardiac troponin T reexamined for three times during hospitalization. No patients experienced cardiovascular death or required coronary revascularization. Conclusion The possibility of short-term onset of MACE is very low in the patients with mild coronary stenosis diagnosed by coronary CT. Although the examination of serial biomarkers will be beneficial for these patients, further diagnostic tests are not necessary.