使用P2-CHA2DS2-VASc得分精确预测与心房相关的中风
Ankit Maheshwari1, Faye L Norby2, Nicholas S Roetker2
1Hospital of the University of Pennsylvania, Philadelphia (A.M.).
Circulation
|December 28, 2018
概括
在CHA2DS2- VASc得分上添加异常的P波轴测量可以显著改善心房动患者的缺血性中风的预测. 这种增强的P2-CHA2DS2-VASc得分为AF相关中风提供了更好的风险分层.
科学领域:
- 心脏病学
- 电心电图
- 预防中风
背景情况:
- 心房动 (AF) 存在缺血性中风的风险.
- 在鼻腔节律期间的P波指数 (PWIs) 可以表明前血栓性心房重塑.
- 目前的风险评分可能无法完全反映AF患者中风风险.
研究的目的:
- 评估P波指数 (PWIs) 是否有助于预测AF相关的缺血性中风.
- 要确定是否添加PWIs到CHA2DS2-VASc得分可以提高其预测准确性.
- 开发一个改进的AF相关中风风险预测工具.
主要方法:
- 使用了ARIC和MESA研究的数据,包括发生肌病的参与者.
- 从AF前心电图 (ECG) 中分析的P波指数 (PWI).
- 使用Cox比例危险模型和使用C统计,净重新分类和综合歧视来评估预测的改进.
主要成果:
- 异常的P波轴是唯一独立的与缺血性中风风险增加相关的PWI.
- 包括P波轴异常 (2分) 的P2- CHA2DS2- VASc得分显著改善了中风预测.
- C-统计数据从0. 60提高到0. 67 (ARIC) 和0. 68提高到0. 75 (MESA).
结论:
- 异常的P波轴反映左心脏异常,增强了AF中缺血性中风的预测.
- 与单独的CHA2DS2- VASc相比,P2- CHA2DS2- VASc得分显示出与AF相关的缺血性中风的更高的预测性能.
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