预测30年心血管疾病风险:弗雷明汉姆心脏研究
Michael J Pencina1, Ralph B D'Agostino, Martin G Larson
1Department of Biostatistics, Boston University, 111 Cummington St, Boston, MA 02215, USA. mpencina@bu.edu
现有的心血管疾病 (CVD) 预测模型太短期了. 这项研究使用Framingham数据开发了一种30年CVD风险预测工具,显示标准风险因素随着时间的推移仍然是关键预测因素.
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:
- 目前的心血管疾病 (CVD) 风险算法通常涵盖10年或更短的随访期.
- 随着预期寿命的增加和风险因素的早期聚类,需要更长期的CVD风险预测工具.
研究的目的:
- 开发和验证一个30年风险预测算法,用于硬心血管疾病 (CVD) 事件.
- 评估长期心血管疾病风险因素的预测性能.
主要方法:
- 来自Framingham Offspring队列 (1971-1974) 的4506名参与者 (20-59岁) 的前性随访.
- 使用修改后的考克斯模型来调整非心血管死亡的竞争风险.
- 通过交叉验证的生存C-统计和校准千平方测试来评估模型性能.
主要成果:
- 开发了一种30年硬CVD事件预测算法,具有出色的性能 (C=0.803).
- 确定标准风险因素 (性别,血压,胆固醇,吸烟,糖尿病) 作为30年心血管疾病风险的重要预测因素.
- 经过对竞争性死亡率进行调整后,30年硬心血管疾病事件率为女性7.6%,男性18.3%.
结论:
- 标准心血管疾病风险因素是30年长的随访期内对硬心血管疾病事件的强有力的预测因素.
- 三十年风险预测提供了有价值的信息,可以补充短期 (10年) 风险评估.
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