对NT-proBNP≥125 pg/mL的临床预测模型的推导和验证,以检测心力衰竭前的情况
Kazutaka Nogi1, Ryohei Yamamoto2, Tomoya Ueda1
1Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan.
Journal of cardiology
|May 29, 2023
概括
一个新的风险评分,BASE-CH评分,有助于识别患有高N端B型亲尿素 (NT-proBNP) 水平的患者,有助于诊断心力衰竭. 这一分数支持对心力衰竭风险患者的临床决策.
科学领域:
- 心脏病学 心脏病学
- 生物标志物研究 生物标志物研究
- 临床预测建模临床预测建模
背景情况:
- 指导方针建议使用N-终端亲B型尿素 (NT-proBNP) 来诊断心力衰竭 (HF).
- 对于在无症状患者中测量NT-proBNP,没有确定的查标准.
- 临床预测模型可以帮助门诊患者做出HF风险评估的决策.
研究的目的:
- 开发和验证高NT-proBNP水平的临床预测模型.
- 支持临床决策在门诊环境中,为患有高风险的患者提供支持.
- 创建一个实际的风险评分,以识别需要NT-proBNP测试的个人.
主要方法:
- 一个多中心队列研究,其中包括导出 (n=837) 和验证 (n=808) 队列.
- 后向渐进逻辑回归用于为最终模型选择预测因子.
- 关键预测因素包括BMI,年龄,静脉血压,eGFR,心胸比率和心脏病,形成了BASE-CH评分.
主要成果:
- 这项研究包括1645名年龄≥65岁的患有HF风险因素的患者.
- 在23.0%的患者中观察到NT-proBNP水平≥125 pg/mL.
- BASE-CH评分显示了良好的诊断性能,AUC为0.74 (内部) 和0.70 (外部验证).
结论:
- 开发并验证了一种新的风险评分,即BASE-CH评分.
- 这一分数有效地预测了高危或HF前患者中NT-proBNP水平的升高.
- BASE-CH评分可以帮助针对HF查进行有针对性的NT-proBNP测量.
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