在中国2型糖尿病患者中验证和比较心血管风险预测方程
Jingyuan Liang1, Qianqian Li1, Zhangping Fu1
1Department of Epidemiology and Biostatistics, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
European journal of preventive cardiology
|June 14, 2023
概括
糖尿病特异性心血管疾病 (CVD) 风险模型在预测糖尿病患者心血管疾病方面表现优于一般人口模型. 不同的模型和特定年龄的截止值显著改变了高风险患者的选择,特别影响了女性.
科学领域:
- 心血管疾病流行病学
- 糖尿病管理 糖尿病管理
- 风险预测建模风险预测建模
背景情况:
- 欧洲指南建议使用糖尿病特异性心血管疾病 (CVD) 风险预测模型,并设置特定年龄的切断值.
- 美国的指导方针建议在糖尿病患者中使用来自一般人群的模型.
- 风险预测模型中的差异需要比较它们在糖尿病人群中的表现.
研究的目的:
- 为了比较四个心血管风险模型在预测中国糖尿病人群中心血管疾病事件的表现.
- 评估糖尿病特定模型 (ADVANCE,HK) 与一般人口模型 (PCE,中国-PAR) 相比.
- 评估年龄特定与固定切断对高风险患者识别的影响.
主要方法:
- 利用来自中国CHERRY研究队列的电子健康记录,包括糖尿病患者.
- 使用原始和重新校准的ADVANCE,HK,PCE和中国-PAR模型计算了5年心血管疾病风险.
- 随访患者的中位数为5.8年,记录了2605次心血管疾病事件.
主要成果:
- 特定于糖尿病的模型 (ADVANCE,HK) 比一般人口模型 (PCE,中国-PAR) 显示出更好的歧视 (更高的C统计).
- 再校准的ADVANCE和PCE模型显示了不同程度的风险低估.
- 特定年龄的切断线导致高风险患者选择的显著变化,与固定的切断线相比,识别的高风险女性较少.
结论:
- 糖尿病特异性心血管疾病风险预测模型为糖尿病患者提供了优越的歧视.
- 在不同模型和切断策略中识别高风险个体存在显著的变化.
- 年龄特定的切断可能导致高风险患者的选择不足,特别是在女性中.
相关概念视频
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
42
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
42
01:23Assessment of the Cardiovascular System I: Subjective Data
375
A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
375
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
127
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
127
01:23Assessment of blood pressure in brachial artery(two-step method)
787
Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
787