怀疑缺血并没有阻塞性冠状动脉疾病 (INOCA) 的妇女的症状表现
Yasmeen K Taha1, Jennifer R Dungan1,2, Michael T Weaver2
1College of Medicine, University of Florida, 1600 Southwest Archer Road, Gainesville, FL 32610, USA.
Journal of clinical medicine
|September 28, 2023
概括
鉴定女性缺血是困难的,因为各种症状. 一个新的模型预测女性没有阻塞性冠状动脉疾病 (INOCA),使用特定的症状和年龄,帮助诊断.
科学领域:
- 心脏病学 心脏病学
- 妇女健康 妇女健康
- 诊断医学 诊断医学 诊断医学
背景情况:
- 在女性中,缺血性心脏病 (IHD) 诊断由于不典型的症状而带来挑战.
- 超过50%的怀疑缺血的女性患有INOCA (没有阻塞性冠状动脉疾病的缺血症),经历了较差的结果.
- 准确预测INOCA对于女性的及时和适当治疗至关重要.
研究的目的:
- 为了确定预测INOCA在女性冠状动脉缺血的临床证据的特定症状.
- 根据症状表现和人口统计因素开发和验证INOCA的预测模型.
主要方法:
- 对来自WISE队列的916名女性进行分析,这些女性因怀疑缺血而接受了冠状动脉血管造影.
- 使用了65项症状问卷和逻辑回归,采用最佳子集方法.
- 开发了一个10个变量模型来预测INOCA,使用AUC和置信区间评估预测能力.
主要成果:
- 一个10变量模型准确地预测了72%的女性的INOCA (AUC 0.72).
- INOCA的预测因素包括年龄较小 (≤55岁),左侧胸痛,胸部不适,部疼痛和心.
- 缺少即将到来的灾难,下巴,手臂或手部疼痛等症状与INOCA有关.
结论:
- 结合年龄和特定症状概况的基于症状的模型显示,它有望预测女性的INOCA.
- 虽然没有得到验证,但该模型突出显示了怀疑缺血症的妇女在基于症状的风险分层的潜力.
- 需要进一步的研究来验证和完善这种模型,以便在诊断女性INOCA时临床应用.
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