安定した冠動脈疾患の患者の心血管疾患のリスクスコアの開発と検証
Peter Ganz1, Bettina Heidecker2, Kristian Hveem3
1Department of Medicine, University of California-San Francisco2Division of Cardiology, San Francisco General Hospital.
JAMA
|June 22, 2016
まとめ
新しい9タンパク質リスクスコアは,既存のモデルと比較して,冠動脈疾患 (CHD) の患者の心血管疾患の予測が改善されたことを示しています. 低リスク集団におけるその正確性を評価するためにさらなる研究が必要である.
科学分野:
- 心血管医学
- プロテオミクス
- バイオマーカーの発見
背景:
- 冠動脈疾患 (CHD) の患者の管理において,正確な心血管リスクの分層化は極めて重要です.
- 既存のリスク予測モデルは,患者の管理の精度を高めるために強化する必要があるかもしれません.
研究 の 目的:
- 心血管疾患の患者に対する新たなリスクスコアを開発し,検証する.
- リスク予測のために広範囲にわたる循環タンパク質分析を活用する.
主な方法:
- 誘導 (ハートとソウル) と検証 (HUNT3) のコホートを含む予期的なコホート研究.
- 改変したアプタマーを用いた1130の血タンパク質の測定.
- 4年間の心筋梗塞,脳卒中,心不全,全因死亡を予測するための9タンパク質リスクスコアの導出と検証.
主要な成果:
- 9タンパク質リスクスコアは,リフィットフレミングハムモデル (C統計0. 64- 0. 66) と比較して優れた予測性能を示した.
- 9タンパク質スコアをフレミングハムモデルに追加することで,誘導と検証コホートの両方のリスク予測が著しく改善されました.
- 9タンパク質モデルでは,心血管疾患を患った患者の年間リスクがより大きく増加しました.
結論:
- 9タンパク質リスクスコアは,フレミングハム二次リスクスコアと比較して,安定したCHD患者の心血管疾患の予測を改善します.
- 9-タンパク質スコアの差別的精度は現在控えめで,さらなる調査が必要である.
- リスクが低い患者集団におけるスコアの有効性を評価するために,追加の研究が推奨されます.
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