基于实验室和非实验室的方法来评估心血管疾病风险:NHANES I后续研究队列
Thomas A Gaziano1, Cynthia R Young, Garrett Fitzmaurice
1Division of Cardiovascular Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA. tgaziano@partners.org
Lancet (London, England)
|March 18, 2008
概括
使用非实验室因素的新型心血管疾病风险预测方法被证明与传统的基于实验室的评估一样准确. 这简化了风险评估,特别是在心血管事件预防的资源有限的环境中.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 心血管疾病 (CVD) 导致全球80%的死亡,主要发生在发展中国家.
- 有效的心血管疾病风险评估对于预防至关重要,但资源限制在许多地区阻碍了基于实验室的策略.
- 这项研究探讨了非实验室风险预测模型作为一种替代方案.
研究的目的:
- 为了比较非实验室的CVD风险预测模型与传统的实验室模型的准确性.
- 确定简化风险评估方法是否可以与资源密集型方法一样有效.
主要方法:
- 利用了来自国家健康和营养检查调查 (NHANES) 队列 (N=6186) 的数据.
- 将实验室模型 (年龄,血压,吸烟,胆固醇,糖尿病,高血压治疗) 与非实验室模型 (替代胆固醇的体重指数) 进行比较.
- 评估了21年来首次致命和非致命心血管事件的预测准确性.
主要成果:
- 这两种模型在男性和女性心血管事件的预测准确度都相似.
- 非实验室模型的女性c统计值为0.831,而实验室模型的女性c统计值为0.829.
- 在男性中,非实验室模型实现了0.783与实验室模型的0.784,对于致命事件的结果相似.
结论:
- 不基于实验室的风险因素可以预测心血管事件的准确度与基于实验室的方法相美.
- 这种简化方法为CVD风险评估提供了一个实际的解决方案,在实验室测试具有挑战性的情况下.
- 这些发现支持在资源有限的环境中实施可访问的风险预测工具.
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