RESUMEN
BACKGROUND: 18F-FDG PET/CT predicts cardiovascular disease. To analyze the predictive value of cardiovascular events from inflammation and arterial calcification in patients who underwent an 18F-FDG PET/CT for lung cancer. METHODS: A retrospective study of 274 patients with primary lung neoplasia. We determined: (i) TBR (target-to-background ratio), and (ii) the calcium score, at eight common arterial segments. We took as arteriosclerosis, a TBR ≥1.6 and ≥15 Calcium Score sum. We registered cardiovascular risk factors, comorbidities, histology, stage, treatment, status at the last clinical review, cause of death and cardiovascular event during the follow-up. RESULTS: The territory presenting the greatest uptake of 18F-FDG, was the thoracic aorta with an average of 1.77 (± 0.27 TBR) in the aortic arch, while the greatest degree of calcification was obtained in the abdominal aorta (52% with a Calcium Score ≥ 3). 24% of the patients presented a sum Calcium Score ≥15, and 17% a TBR ≥1.6. Patients with high TBR, (17%), had not a higher frequency of cardiovascular comorbidities beforehand, nor did they in the follow-up. However, those with a sum Calcium Score ≥15 (24%), were older, had more cardiovascular risk factors and ischemic events during follow-up. The calcium score, but not the TBR, predicted the emergence of a cardiovascular event (HR 4.9 IC95% 2.1-9.1, P < 0.05). CONCLUSION: In our cohort, a high Calcium Score was an independent predictor for developing cardiovascular events.
Asunto(s)
Arteritis/fisiopatología , Neoplasias Pulmonares/diagnóstico por imagen , Anciano , Aorta Abdominal/diagnóstico por imagen , Aorta Torácica/diagnóstico por imagen , Aterosclerosis/complicaciones , Aterosclerosis/diagnóstico , Calcinosis/complicaciones , Calcinosis/diagnóstico , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/diagnóstico , Femenino , Fluorodesoxiglucosa F18 , Humanos , Neoplasias Pulmonares/complicaciones , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de RiesgoRESUMEN
A clinical study of 44 eyes in 22 patients with cortisone-induced glaucoma confirmed the importance of the duration of employ of the corticoid. Those patients who had instilled the medication for less than 8 weeks recovered normal ocular tension after discontinuation of the corticoid. On the contrary, those who had employed the corticoid for more than 4 years did not regain normal ocular tension, and medical treatment, or even surgical therapy in a large number of cases, had to be employed. The frequency of congenital anomalies of the angle has to be emphasized, particularly persistence of the pectinate ligament. Papilla asymmetry was noted in a large percentage of cases, and was related to the difference in the stage of evolution of the eyes. The appearance of the papilla has important prognostic value. Of the patients with abnormal papilla, 61.9 p. cent had normal ocular tension after stopping treatment, but normal tension did not appear in patients with anexcavated and apale papilla. The authors consider trabeculotomy to be the operation of choice in cortisone induced glaucoma, but this tends to be ineffective in young patients because of sclerous and/or conjunctival blocking.