P2-CHA2DS2-VAScスコアを使用して,心房動に関連した脳卒中を精密に予測する
Ankit Maheshwari1, Faye L Norby2, Nicholas S Roetker2
1Hospital of the University of Pennsylvania, Philadelphia (A.M.).
Circulation
|December 28, 2018
まとめ
CHA2DS2- VAScスコアに異常なP波軸の測定を加えると,心房細動 (AF) の患者の血性脳卒中の予測が著しく改善されます. このP2-CHA2DS2-VAScスコアは,AF関連の脳卒中のリスクの階層化を改善します.
科学分野:
- 心臓病科
- エレクトロカルジオグラフィー
- 脳卒中 の 予防
背景:
- 動脈動 (AF) は,不全性脳卒中のリスクをもたらします.
- シヌスリズム中のP波インデックス (PWIs) は,前血栓性心房改造を示す可能性があります.
- 現在のリスクスコアは,AF患者における脳卒中リスクを完全に捉えていない可能性があります.
研究 の 目的:
- P波インデックス (PWI) がAFに関連する不全性脳卒中の予測を改善するかどうかを評価する.
- CHA2DS2-VAScスコアにPWIを追加することで予測精度が向上するかどうかを判断する.
- AF関連の脳卒中のリスク予測ツールを開発する.
主な方法:
- ARICとMESAの研究から得られたデータを利用し, 発作性関節炎の被験者を含む.
- 分析されたP波インデックス (PWIs) が,AF前の心電図 (ECG) から得られた.
- C統計,純再分類,統合的差別を用いたコックスの比例リスクモデルと予測の改善を評価した.
主要な成果:
- 異常なP波軸は,独立して増加した不全性脳卒中リスクと関連した唯一のPWIでした.
- P- CHA- 2DS- VAScスコアは,異常なP波軸 (2点) を含め,脳卒中の予測を大幅に改善しました.
- C統計は,0. 60から0. 67 (ARIC) と0. 68から0. 75 (MESA) に改善されました.
結論:
- 左心房の異常を反映したP波軸の異常は,AFにおける不全性脳卒中の予測を高めます.
- P2- CHA2DS2- VAScスコアは,CHA2DS2- VASc単独と比較して,AF関連性不全性脳卒中の優れた予測性能を示しています.
関連する概念動画
Amyloid Fibrils
11.9K
Amyloid fibrils are aggregates of misfolded proteins. Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils.
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
11.9K
Amyloid Fibrils
6.4K
6.4K
Introduction to z Scores
11.2K
A z score (or standardized value) is measured in units of the standard deviation. It tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
z scores...
z scores...
11.2K
Introduction to z Scores
1.3K
A z score (or standardized value) is measured in units of the standard deviation. It indicates how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
z scores...
z scores...
1.3K
z Scores and Area Under the Curve
19.6K
z scores are the standardized values obtained after converting a normal distribution into a standard normal distribution. A z score is measured in units of the standard deviation. The z score tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a z score of...
19.6K
Fibril-associated Collagen
3.4K
Fibril-associated collagens are a type of collagens present in the extracellular matrix with interrupted triple helices or FACIT (Fibril-associated collagens interrupted triple-helices). FACIT help connect and attach the collagen fibrils with each other as well as with other proteins of the extracellular matrix.
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
3.4K


