通过运动测试和Framingham风险评分,对无症状个体进行了增强的风险评估
Samia Mora1, Rita F Redberg, A Richey Sharrett
1Center for Cardiovascular Disease Prevention, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical Schoo, Boston, MA, USA. smora2@partners.org
Circulation
|September 8, 2005
概括
将运动能力和心率恢复添加到弗雷明汉风险评分中,可以显著改善无症状个体的心血管疾病风险预测. 这些措施可以识别仅使用FRS错过的高风险患者,从而增强临床评估.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 运动生理学 运动生理学
背景情况:
- 目前的指南使用弗雷明汉风险评分 (FRS) 来评估无症状个体的心血管风险.
- 该研究调查了运动测试措施是否可以提高FRS的准确性.
研究的目的:
- 为了确定运动能力 (MET) 和心率恢复 (HRR) 是否可以改善心血管疾病 (CVD) 风险预测,超出FRS.
- 评估MET和HRR与FRS的综合预测值.
主要方法:
- 对6126个无症状个体进行了20年的预期随访,并进行了基线跑步机测试.
- 对心血管疾病 (CVD) 死亡与FRS,MET和HRR相关的分析.
- 调整的危险比率被计算出来,以评估独立和组合的预测值.
主要成果:
- 低MET或HRR的确定的个人占心血管疾病死亡人数的91%.
- 与高MET/高HRR相比,低MET和HRR的组合显著增加了心血管疾病死亡风险 (例如,女性:8.51,男性:3.53).
- 这项综合评估确定了高风险个体,仅由FRS遗漏,特别是在中等风险群体.
结论:
- 运动测试 (MET和HRR) 是FRS的宝贵补充,用于对无症状个体进行风险评估.
- 它特别有利于FRS 6%-19%的女性和FRS 10%-19%的男性.
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