心血管疾患リスクの評価のための実験室ベースの対非実験室ベースの方法:NHANES Iフォローアップ研究コホート
Thomas A Gaziano1, Cynthia R Young, Garrett Fitzmaurice
1Division of Cardiovascular Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA. tgaziano@partners.org
Lancet (London, England)
|March 18, 2008
まとめ
非実験室要因を用いた新しい心血管疾患リスク予測方法は,従来の実験室での評価と同じくらい正確であることが証明されました. これにより,リスク評価が簡素化され,特に心血管疾患の予防のためのリソースが限られた環境では,リスク評価が簡素化されます.
科学分野:
- 心臓病学 心臓病学
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
背景:
- 心血管疾患 (CVD) は,世界の死亡者の80%の原因であり,主に開発途上国です.
- 効果的なCVDリスク評価は予防に不可欠ですが,資源の制限は多くの地域で研究室ベースの戦略を妨げています.
- この研究では,代替案として非実験室ベースのリスク予測モデルを探求しました.
研究 の 目的:
- 非研究室ベースのCVDリスク予測モデルの正確さを,従来の研究室ベースのモデルと比較するために.
- 簡素化されたリスク評価方法が,資源密集的な方法と同じくらい有効であるかどうかを判断する.
主な方法:
- 国家保健栄養調査 (NHANES) のコホート (N=6186) のデータを活用した.
- 実験室ベースのモデル (年齢,血圧,喫煙,コレステロール,糖尿病,高血圧治療) と非実験室モデル (コレステロールの代用体量指数) を比較した.
- 21年以上にわたって,初めて致命的および非致命的な心血管イベントの予測精度を評価しました.
主要な成果:
- 両モデルとも,男性と女性の心血管疾患の予測の精度が類似していることが示されました.
- 非ラボベースのモデルは,女性では0.831のc統計を示し,ラボベースのモデルは0.829でした.
- 男性では,非実験室モデルでは0.783対0.784を,実験室ベースのモデルでは0.783対0.784を達成し,致死事故でも同様の結果となりました.
結論:
- 非実験室ベースのリスクファクターは,実験室ベースの方法と同等の精度で心血管疾患を予測することができます.
- この簡素化されたアプローチは,実験室での検査が困難である場合,CVDリスク評価のための実用的な解決策を提供します.
- この発見は,資源が限られた環境で,アクセス可能なリスク予測ツールの実装を支援します.
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