在临床实践中ACC/AHA聚合队列心血管风险方程的表现
Jose R Medina-Inojosa1, Virend K Somers2, Mariana Garcia3
1Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA; Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Journal of the American College of Cardiology
|October 4, 2023
概括
美国心脏病学会/美国心脏协会的聚合队列方程 (PCE) 准确地预测了在现实环境中的动脉样硬化心血管疾病 (ASCVD) 风险. 它的性能即使在标准范围之外的值或使用他类药物时也保持稳健.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 美国心脏病学会/美国心脏协会聚合队列方程 (PCE) 对动脉样硬化心血管疾病 (ASCVD) 风险预测在现实世界临床实践中的表现没有得到广泛评估.
- 现实世界的验证对于理解心血管风险预测模型的适用性至关重要.
研究的目的:
- 评估PCE对ASCVD风险在基于社区的队列中的预测性能.
- 为了确定是否包括具有范围外值 (年龄,血压,胆固醇) 或他类药物启动的个体会影响PCE的预测能力.
主要方法:
- 使用社区基队列 (1997-2016) 来自明尼苏达州奥尔姆斯特德县的PCE验证.
- 通过罗切斯特流行病学项目的记录链接系统确定患者信息.
- 双重验证ASCVD事件 (心肌梗塞,缺血性中风) 和计算与观察风险和c-统计数据的比较.
主要成果:
- 该研究包括30,042名成年人,平均随访时间为16.5年 (截至10年).
- PCE的整体表现良好 (c-统计值为0.78),各个子组的表现有所不同.
- 范围之外的值和他类药物启动并没有显著影响模型的预测性能.
结论:
- 在现实世界的临床实践环境中,PCE表现良好.
- 目前基于PCE的ASCVD预防策略甚至适用于标准范围以外的值或接受他类药物治疗的患者.
- 研究结果支持PCE在不同患者群体中的实用性,用于ASCVD风险评估.
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