对心房的风险评分的制定 (弗雷明汉心脏研究):基于社区的队列研究
Renate B Schnabel1, Lisa M Sullivan, Daniel Levy
1Framingham Heart Study, Framingham, MA, USA; Department of Medicine II, Johannes Gutenberg-University, Mainz, Germany.
Lancet (London, England)
|March 3, 2009
概括
使用现有临床因素的新风险评分可以预测10年心房动风险. 心声图测量在预测这种常见的心脏病的过程中提供了很小的改善.
科学领域:
- 心脏病学 心脏病学
- 流行病学 流行病学
- 预防医学 预防医学
背景情况:
- 心房动 (AF) 显著增加了发病率和死亡率.
- 开发准确的AF风险预测工具对于患者的治疗结果至关重要.
- 需要一个框架来评估新的风险标志物.
研究的目的:
- 开发一个风险评分来预测发展心房的绝对风险.
- 为评估AF的新风险标志物提供研究框架.
- 评估心肌梗塞风险预测中心声谱测量的附加值.
主要方法:
- 分析了来自弗雷明汉心脏研究 (1968-1987) 的4764名参与者,随访时间长达10年.
- 多变量考克斯回归用于确定心房的临床风险因素.
- 二次分析包括心声回声数据,以评估风险重新分类和预测改进.
主要成果:
- 风险评分包括年龄,性别,BMI,缩血压,高血压治疗,PR间隔,心脏声和心力衰竭预测了10年AF风险 (C统计值0.78).
- 根据年龄,10年AF风险因年龄而异,65岁以上的个人风险要高得多.
- 心声测量略有改善了预测模型 (C-统计值0.79),但并没有显著改善风险重新分类.
结论:
- 一个初级保健可访问的风险评分可以识别患有心房的风险的人.
- 开发的评分有助于评估新的风险标志物和针对预防策略.
- 常规心声回声测量为AF风险预测提供了有限的额外益处,超出了已确定的临床因素.
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