心血管疾患リスクのスクリーニング:米国予防サービスタスクフォースの勧告声明
, Susan J Curry1, Alex H Krist2,3
1University of Iowa, Iowa City.
JAMA
|June 14, 2018
まとめ
心血管疾患 (CVD) のスクリーニングは,無症状の成人に対して,心電図 (ECG) を用いて行うことは推奨されません. 中等または高リスクの成人の場合,証拠は不十分であり,潜在的な害は利益に優れている.
科学分野:
- 心血管医学
- 予防的な心臓科
- 診断検査
背景:
- 心血管疾患 (CVD) は米国における主要な死因であり,フレミングハムリスクスコアのようなリスク評価ツールが予防戦略を導く.
- 現在,心血管疾患の予防に関するガイドラインは,無症状の成人の治療決定を基にリスクの階層化に基づいています.
研究 の 目的:
- 電気心臓図 (ECG) を用いた冠動脈疾患のスクリーニングに関する米国予防サービスタスクフォース (USPSTF) の勧告を更新する.
- 無症状の成人の伝統的なリスク評価と比較して,EKGスクリーニングの有効性を評価する.
主な方法:
- 無症状の成人の休憩または運動時のECGスクリーニングに関する証拠の体系的なレビュー.
- ECGスクリーニングと従来のCVDリスク評価の健康結果の比較
主要な成果:
- 低リスクの無症状の成人の場合,ECGスクリーニングは既存のリスク評価を超えて最小限の利益をもたらし,その後の侵襲的な処置から潜在的な害をもたらします.
- 中期および高リスクの無症状の成人の場合,ECGスクリーニングがリスク管理を改善するか,心血管疾患の発生を軽減するかどうかを判断するには,証拠は不十分です.
結論:
- USPSTFは,リスクが低い無症状の成人の場合,可能性の低い利益と潜在的な害のために,ECGスクリーニングを推奨しない.
- USPSTFは,中期または高リスクの無症状成人のECGスクリーニングの利益と害を評価するのに十分な証拠が見つかりませんでした.
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