在相对健康的美国人中心脏生物标志物升高. 大人的成年人
Sophie E Claudel1, Insa M Schmidt2, Deepa M Gopal3
1Department of Medicine, Boston Chobanian & Avedisian School of Medicine, Boston, MA.
medRxiv : the preprint server for health sciences
|December 11, 2023
概括
诸如hs-cTnT和NT-proBNP等心脏生物标志物的升高预测了看似健康的成年人心血管疾病 (CVD) 死亡率. 新的风险分层是必要的,因为传统因素可能会错过有风险的个体.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 生物标志物研究 生物标志物研究
背景情况:
- 早期心血管疾病 (CVD) 干预至关重要,但缺乏传统风险因素 (如糖尿病,高血压) 的成年人风险评估的数据有限.
- 在看似健康的个体中评估心血管疾病风险是具有挑战性的,因为对于这一群体缺乏确定的查协议.
研究的目的:
- 调查心脏生物标志物与没有传统心血管疾病风险因素的成年人心血管疾病死亡率之间的关联.
- 在看似健康的人群中确定心血管风险分层的潜在新型标志物.
主要方法:
- 来自1999-2004年国家健康和营养检查调查的4,544名成年人的分析.
- 排除患有糖尿病,高血压,慢性病或患有心血管疾病的参与者.
- 使用多变量调整的考克斯比例危险回归来评估心脏生物标志物 (hs-cTnT,hs-cTnI,NT-proBNP) 与心脏病死亡率的关系.
主要成果:
- 在8.7%的队列中发现了高水平的hs-cTnT或NT-proBNP.
- 每一次hs-cTnT的翻倍都与49%的心血管疾病死亡风险增加有关 (HR 1.49).
- 每次NT-proBNP的翻倍都与心血管疾病死亡率增加41%的风险有关 (HR 1.38).
- 特定的hs-cTnI测定 (Abbott,Ortho) 也显示出与心血管疾病死亡率的显著关联.
结论:
- 即使是年轻,健康的人也可能存在隐秘的心血管疾病风险.
- 标准心血管疾病风险因素可能无法识别有风险的子群体.
- 新的风险分层方法对于全面的全民心血管疾病减少策略至关重要.
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