对大动脉脉冲波速的结果驱动值的推导:一个个人参与者的元分析
De-Wei An1,2,3, Tine W Hansen2,4, Lucas S Aparicio5
1Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (D.-W.A., Q.-F.H., Y. B.C., C. S.S., J. G.W., Y.L.).
Hypertension (Dallas, Tex. : 1979)
|July 20, 2023
概括
9米/秒的大动脉脉冲波速度 (PWV) 的新结果驱动值预测心血管事件和总死亡率. 这一发现可以指导对动脉硬和相关风险的临床管理.
科学领域:
- 心血管研究的心血管研究.
- 动脉生物力学 动脉生物力学
- 风险分层是指风险的分层.
背景情况:
- 大动脉脉冲波速度 (PWV) 是心血管事件 (CVEs) 和总死亡率 (TM) 的预测指标.
- 之前关于可采取行动的PWV值的研究缺乏通用性.
- 这项研究定义并验证了基于结果的PWV值.
研究的目的:
- 定义,测试校准和验证PWV的结果驱动的值.
- 为预测CVE和TM建立一个PWV值.
- 使用已确定的指标评估值的预测性能.
主要方法:
- 使用IDCARS和MONICA种群进行的个人参与者元分析.
- 多变量考克斯回归来定义带有风险的PWV值.
- 确定的值产生5年风险,相当于静缩血压为140毫米升.
- 使用综合歧视改进和净重新分类改进评估预测性绩效.
主要成果:
- 具有风险的PWV值在经过精确校准的模型中以9m/s的速度趋同.
- 9m/s PWV值预测了IDCARS和MONICA队伍中的CVE和TM.
- 两个终点的预测准确度大约为0.75.5.
- 在蒙尼卡的TM和CVE中观察到显著的综合歧视改善.
结论:
- 建立了一个基于结果的PWV值9 m/s.
- 这个值预测心血管事件和总死亡率.
- 超过这个PWV值需要严格的风险因素管理,特别是高血压.
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