改善心血管风险预测和预防的新得分
Rosaria Del Giorno1, Maud Reveilhac2, Iris Stauffer1
1Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
概括
将动脉样硬化负担评分 (ABS) 与弗雷明汉风险评分 (FHRS) 结合到新的FHRABS评分中,可以显著改善初级预防中的心血管风险预测. 这种新的得分可以提高对患有重大心血管不良事件高风险的患者的检测.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 预防性心脏病学 预防性心脏病学
背景情况:
- 通过超声波检测的亚临床动脉样硬化 (scATS) 改善了超越传统因素的心血管 (CV) 风险分层.
- 提高scATS评估的预测价值对于有效的CV风险管理至关重要.
- 动脉样硬化负担评分 (ABS) 量化了scATS,但其与现有风险评分的整合需要进一步研究.
研究的目的:
- 调查是否将ABS纳入Framingham风险评分 (FHRS) 改善了初级预防环境中的CV风险预测.
- 开发和验证一种新的综合评分,即FHRABS,用于增强心血管风险分层.
- 评估ABS和FHRABS对主要心血管不良事件 (MACE) 的增量预测值.
主要方法:
- 一项前性观察队列研究包括了1024名患者,他们接受了动脉和股骨斑块的超声波检测.
- 主要心血管事件 (MACEs) 被前性地收集,平均随访时间为6.0±3.3年.
- 接收机运行特征曲线分析 (ROC-AUC) 和尤登指数 (Ysi) 用于比较预测模型.
主要成果:
- 在随访期间,共发生60例初级MACE (5.8%).
- 与单独使用FHRS (0.71) 相比,FHRABS显示MACE预测的ROC-AUC (0.74) 显著更高.
- ABS (0.71) 也显示出比FHRS更好的预测,FHRABS在MACE预测中产生了最高的Ysi (42%).
结论:
- FHRABS是改进CV风险分层和识别未来MACEs高风险个人的一个有价值的工具.
- 将ABS集成到FHRS中显著提高了CV预测性能,正如Cox比例危险模型所显示的那样.
- FHRABS提供一种简单,无辐射的scATS检测方法,以促进个性化的心血管预防策略.
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