非伝統的な危険因子による心血管疾患のリスク評価:米国予防サービスタスクフォースの勧告声明
PubMedで要約を見る
まとめ
この要約は機械生成です。心血管疾患 (CVD) リスクモデルにABI,hsCRP,CACなどの非伝統的なリスクファクターを追加すると,わずかな改善が見られるが,明確な臨床的意味がない. 心血管疾患を予防する効果を評価するには,さらなる証拠が必要である.
科学分野
- 心臓病科
- 予防医学
- 健康リスク評価
背景
- 心血管疾患 (CVD) は,米国における主要な死因です.
- フレミングハムリスクスコアや プールされたコホート方程式などの現在のCVDリスク評価モデルは,予防的な治療をガイドしています.
- 追加の要因を組み込むことでリスク評価を改善することで,治療のターゲティングと結果を向上させることができます.
研究 の 目的
- 冠動脈疾患のリスク評価における非伝統的な危険因子の使用に関する勧告を更新する.
- 既存のCVDリスクモデルに非伝統的なリスクファクターを追加した影響を評価する.
主な方法
- 足首-腕指数 (ABI),高感度C反応性タンパク質 (hsCRP),冠動脈カルシウム (CAC) のスコアに関する証拠の体系的なレビュー.
- リスク評価と治療の利益と害の評価は,これらの非伝統的な要因によって導かれます.
- モデルの校正,差別化,リスク再分類の改善の評価
主要な成果
- 既存のモデルにABI,hsCRP,CACのスコアを追加すると,差別とリスク再分類のわずかな改善が示されましたが,臨床的意義は不明です.
- プーリングされたコホート方程式にこれらの因子を加えるための証拠は限られている.
- これらの追加が心血管疾患の発生や死亡率を減少させるかどうかを判断する十分な証拠はない.
- 早期発見と介入に伴う害は小さいことが判明しました.
結論
- 症状のない成人のCVDリスク評価において,ABI,hsCRP,またはCACスコアの使用の利益と害のバランスを決定するには,現在の証拠は不十分である.
- 米国予防サービスタスクフォース (USPSTF) は,証拠が不十分であることを示す"I"声明を出した.
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