冠状动脉不能准确地预测高风险成年人近期的冠状动脉事件
R C Detrano1, N D Wong, T M Doherty
1Division of Cardiology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502-2064, USA. detrano@harbor4.humc.edu
Circulation
|May 25, 1999
概括
传统的风险模型和冠状动脉分数是冠状动脉事件在高风险无症状成年人的不良预测. 两种方法都不能准确地识别可能经历心脏事件的个人.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 预防医学 预防医学
背景情况:
- 预后风险模型在预测具有多个风险因素的受试者冠状动脉事件方面取得了有限的成功.
- 通过放射检测的冠状动脉是一种替代性预测剂.
- 这项研究比较了风险模型的预测价值和无症状成年人的冠状动脉与多种风险因素.
研究的目的:
- 评估和比较传统风险模型与冠状动脉评分的预测价值,以确定冠状动脉事件风险.
- 评估综合风险模型的预测价值,包括分数和心脏风险因素.
主要方法:
- 招募了1196名无症状的冠状动脉高风险患者.
- 参与者接受了风险因素评估和心脏电子束CT (EBCT) 扫描.
- 随访时间为41个月,成功率为99%.
主要成果:
- 平均年龄为66岁,平均3年Framingham风险为3.3%.
- 68%的受试者有可检测的冠状动脉.
- 对于Framingham,数据衍生模型和评分的接收器操作特征 (ROC) 曲线区域没有显著差异 (分别为0.69,0.68,0.64).
- 在数据衍生模型中包括分数并没有显著改善ROC区域 (0.71).
结论:
- 无论是风险因素评估还是EBCT都不能准确地预测高风险无症状成年人的事件.
- 除了现有的风险因素之外,EBCT评分没有提供显著的增量信息.
- 目前在临床查中使用EBCT分数是不合理的.
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