冠状动脉量化和分布用于冠状动脉血管疾病风险重新分类在初级预防设置中的使用
Adel Hajj Ali1, Michael Nakhla1, Leslie Cho1
1Heart Vascular Thoracic Institute (HVTI), Cleveland Clinic, Cleveland, Ohio.
The American journal of cardiology
|September 18, 2023
概括
冠状动脉评分 (CACS) 与传统评分相比,显著重新分类心血管疾病风险. 亚临床动脉样硬化多民族研究 (MESA-CACS) 提供了比ASCVD和雷诺兹风险评分更准确的初级预防评估.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 放射学 放射学是一门学科.
背景情况:
- 心血管疾病 (CVD) 风险分层对于初级预防至关重要.
- 传统的风险评分,如ASCVD和雷诺兹风险评分 (RRS),在准确评估无症状个体的风险方面存在局限性.
- 亚临床动脉样硬化检测,特别是冠状动脉评分 (CACS),可以改善风险预测.
研究的目的:
- 将亚临床动脉样硬化CACS多民族研究 (MESA-CACS) 提供的风险重新分类与已确定的动脉样硬化心血管疾病 (ASCVD) 和雷诺兹风险评分 (RRS) 进行比较.
- 评估CACS对在接受初级预防查的无症状中年个体风险分层的影响.
主要方法:
- 分析了5,324名无症状中年人 (57±8岁,76%男性) 接受了CACS查的队列.
- 计算和分类了10年的ASCVD,RRS和MESA-CACS风险得分.
- 风险重新分类 (升级和降级) 在MESA-CACS和传统分数之间进行了比较.
主要成果:
- 与ASCVD相比,MESA-CACS在45%的患者中重新分类了风险 (31%的降级,14%的升级).
- 与RRS (26%降级,15%升级) 相比,MESA-CACS在41%的患者中重新分类了风险.
- ASCVD高估了患有0-1病动脉的患者的风险,而RRS高估了0 CAC的风险,但低估了任何CAC的风险.
结论:
- 结合冠状动脉 (CAC) 分布的MESA-CACS,在初级预防中显著重新分类了10年冠状动脉疾病风险.
- 与ASCVD和RRS相比,MESA-CACS提供了更准确的风险评估,在某些患者子组中,RRS低估了风险,ASCVD高估了风险.
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