冠状动脉在提炼10年ASCVD风险预测中的实用性,使用泰国心血管风险评分
Noppanat Tiansuwan1, Thinnakrit Sasiprapha1, Sutipong Jongjirasiri2
1Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Thailand.
Frontiers in cardiovascular medicine
|November 29, 2023
概括
冠状动脉 (CAC) 扫描显著改善无症状患者的心血管风险预测. 将CAC评分添加到泰国风险评分中可以提高预测10年动脉样硬化心血管疾病 (ASCVD) 事件的准确性.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 医疗成像医学成像
背景情况:
- 冠状动脉 (CAC) 扫描是评估心血管 (CV) 风险的既定工具.
- 传统的心血管风险评分可能无法完全捕捉所有患者群体的风险.
- 对现有的风险预测模型进行新增的评估对于个性化医学至关重要.
研究的目的:
- 评估冠状动脉 (CAC) 评分是否可以改善泰国心血管 (CV) 风险评分的预测性能.
- 确定CAC对预测10年动脉样硬化心血管疾病 (ASCVD) 风险在具有CV风险因素的无症状患者中的影响.
主要方法:
- 对无症状,有心血管风险因素的患者进行了回顾性队列研究,这些患者接受了CAC扫描 (2005-2013).
- 根据泰国CV风险评分分层的患者 (低,中等,高).
- CAC评分分别分析 (0, 1-99, ≥100) 和作为自然日志变量;用于评估的C统计和净重新分类改进 (NRI).
主要成果:
- 分析了6964名患者,75.3%的低风险,20.5%的中等风险.
- 在低风险和中等风险组中,CAC≥100的患者显示出显著更高的CV事件率.
- 结合ln(CAC+1) 将C统计从0.703提高到0.716,并产生了0.06的NRI;用ln(CAC+1) 的修订模型达到0.771.1的C统计.
结论:
- 将CAC扫描添加到传统的风险因素中,显著提高了心血管风险分层和ASCVD预测.
- CAC评分提供了超越现有风险评分的有价值的增量信息.
- 需要进一步的研究来证实对CV事件减少和成本效益的临床影响.
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