在新西兰初级保健中对14000多名癌症幸存者的心血管疾病风险预测方程的性能:一个验证研究
Essa Tawfiq1, Vanessa Selak1, J Mark Elwood1
1School of Population Health, University of Auckland, Auckland, New Zealand.
Lancet (London, England)
|January 26, 2023
概括
新西兰心血管疾病风险方程可以合理预测癌症幸存者的风险. 进一步的改进可能涉及癌症特异性因素和更好的临床工具的竞争风险.
科学领域:
- 心脏病学
- 癌症学
- 流行病学
背景情况:
- 癌症幸存者面临心血管疾病 (CVD) 的高风险.
- 现有的新西兰心血管疾病风险预测方程在一般人群中得到了验证.
- 这项研究对新西兰的癌症幸存者进行了评估.
研究的目的:
- 评估新西兰心血管疾病风险预测方程在癌症幸存者的表现.
- 确定当前方程是否适用于该人群.
- 确定改善癌症幸存者的心血管疾病风险预测的潜在领域.
主要方法:
- 使用了PREDICT队列研究 (n=14,263) 的数据,包括至少2年前被诊断出癌症的幸存者.
- 对性别特异性心血管疾病风险方程进行了校准 (观察与预测风险) 和歧视 (哈雷尔C统计).
- 方程包括年龄,种族,贫困,家庭史,吸烟,心肌梗塞,糖尿病,血压,胆固醇比例和药物.
主要成果:
- 方程显示了合理的校准,观察到的风险预测低至3.2%.
- 在临床风险组中,低风险组的低预测率为< 2%,最高风险组的轻微超预测率为 (2. 2- 3. 3%).
- 歧视是可以接受的,哈雷尔的C统计数据为男性0.67和女性0.73.
结论:
- 新西兰心血管疾病风险预测方程为癌症幸存者提供了合理的临床效用.
- 改进,例如纳入癌症特异变量和竞争风险,可以进一步完善预测准确性.
- 这些发现支持将这些方程作为管理新西兰癌症幸存者的心血管疾病风险的临床工具.
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