在2型糖尿病患者中评估动脉血风险
David D Berg1, Filipe A Moura1, Andrea Bellavia1
1TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Journal of the American College of Cardiology
|June 21, 2023
概括
一个新的风险评分识别了2型糖尿病 (T2DM) 患有心脏病发作或中风等动脉血事件的高风险的患者. 这个工具有助于个性化预防策略和药物选择.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 临床风险预测预测
背景情况:
- 在2型糖尿病 (T2DM) 患者中,动脉血事件的风险在很大程度上不同.
- 个性化风险评估对于指导T2DM患者心血管初级和二级预防药物治疗至关重要.
研究的目的:
- 开发和验证T2DM患者动脉血栓的预测风险模型.
主要方法:
- 来自4个TIMI试验的42,181名T2DM患者的综合队列被用于开发和验证肌动脉梗塞 (MI) 或缺血性中风 (IS) 的风险模型.
- 多变量考克斯回归确定了16个独立预测因素 (P < 0.05). 评估了模型歧视和校准.
- 在特定的临床试验中,对达帕格利弗洛辛和埃沃洛库马布的治疗相互作用进行了探索.
主要成果:
- 最终的模型确定了16个MI或IS的独立预测因素.
- 在最高和最低风险五分位数之间观察到MI/IS率的8倍以上的梯度 (3年率:14.9%对1.4%).
- 该模型显示了良好的歧视 (C指数为0.704-0.706) 和对初级和二级预防的校准.
结论:
- 通过在T2DM患者中使用16个例行评估的临床变量,开发了一种对动血栓事件的验证风险评分.
- 这种风险评分有可能增强临床决策和改善风险分层.
- 该得分可能有助于为T2DM患者量身定制心血管预防策略.
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