在社区人口中验证Framingham一般心血管风险评分和聚合队列方程:前性队列研究分析2006-2017年
Jia-Zhen Jian1, I-Shiang Tzeng2, Chuan-Fa Hsieh3
1Division of Medical Research, Landseed International Hospital, Taoyuan.
Acta Cardiologica Sinica
|November 29, 2023
概括
弗雷明汉风险评分 (FRS-CVD) 和聚合队列方程 (PCE) 显示了对预测台湾人10年动脉样硬化心血管疾病 (ASCVD) 风险的良好校准. 这些分数提供了适度的歧视,除了女性的PCE,帮助初级CVD预防策略.
科学领域:
- 心血管疾病流行病学
- 风险预测模型 风险预测模型
- 公共卫生 公共卫生
背景情况:
- 动脉样硬化心血管疾病 (ASCVD) 的10年风险对于心血管疾病 (CVD) 的初级预防至关重要.
- 弗雷明汉风险评分 (FRS-CVD) 和聚合队列方程 (PCE) 在西方人群中被广泛使用,但在台湾队列中缺乏验证.
研究的目的:
- 验证FRS-CVD和PCE用于评估台湾社区人口的10年ASCVD风险.
- 评估这些风险分数在亚洲队列中的歧视力和校准.
主要方法:
- 利用了陆地种子综合推广社区选登记 (基于社区的前性队列研究) 的数据.
- 分析了2006年至2017年的心血管事件,使用电子医疗记录.
- 评估了FRS-CVD和PCE的区分能力和校准.
主要成果:
- 包括5139名受试者,99.6%的10年随访率.
- FRS-CVD显示了良好的校准 (男性: χ2=7.03,p=0.63;女性: χ2=7.88,p=0.55) 和适度的歧视 (男性: AUROC=0.76;女性: AUROC=0.71).
- 在男性 (χ2=13.01,p=0.16) 中,PCE 显示出良好的校准,但在女性 (χ2=38.79,p<0.001) 中,校准较差,歧视程度较小 (男性:AUROC=0.68;女性:AUROC=0.61).
结论:
- FRS-CVD和PCE在未曾服用过他类药物的台湾人中,对ASCVD风险进行了良好的校准和适度的歧视.
- 聚合队列方程 (PCE) 显示女性的校准不佳,这表明这个子组的潜在局限性.
- 这些发现支持FRS-CVD和PCE在台湾人口中谨慎使用用于初级心血管疾病预防.
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