外围内皮功能对主要心血管不良事件的预后值高于传统风险因素
Nazanin Rajai1, Takumi Toya1,2, Jaskanwal D Sara1
1Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55902, USA.
European journal of preventive cardiology
|July 11, 2023
概括
周围微血管功能障碍 (PMED) 独立预测主要不良心血管事件 (MACE). 非侵入性地评估内皮功能可以改善高风险患者的心血管风险分层.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 动脉样硬化研究 动脉样硬化研究
背景情况:
- 已确定的心血管风险得分可能无法完全捕捉个体患者的风险.
- 周围微血管功能障碍 (PMED) 是动脉样硬化的新兴标志物.
- 早期发现内皮功能障碍对于预测心血管事件至关重要.
研究的目的:
- 为了确定是否将PMED添加到现有的风险得分中,可以改善预测主要不良心血管事件 (MACE) 的情况.
- 为了评估MACE的反应性高血压指数 (RHI) 的预后值.
- 评估PMED作为心血管事件的独立预测因素.
主要方法:
- 对1460名患者 (2006-2020年) 进行外周动脉度测试的回顾性分析.
- 为MACE预测计算的最佳反应性高血压指数 (RHI) 截止值.
- 使用传统因素 (CHA2DS2-Vasc,Framingham) 进行MACE风险比较,使用和不使用PMED.
主要成果:
- 确定了最佳的RHI切断点 (总体为1.83,根据性别有所不同).
- 周围微血管功能障碍 (PMED) 与明显更差的无MACE生存率相关 (P < 0.001).
- 多变量分析证实PMED是MACE的独立预测因子,即使经过对传统风险因素和得分进行调整.
结论:
- 周围微血管功能障碍 (PMED) 是主要心血管不良事件 (MACE) 的重要独立预测因素.
- 与RHI一样,对外围内皮功能进行非侵入性评估有助于早期检测.
- 纳入PMED评估可以提高高风险个体的心血管风险分层.
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