对于有或没有动脉样硬化心血管疾病的个体的普遍风险预测
Yejin Mok1, Zeina Dardari2, Yingying Sang1
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Journal of the American College of Cardiology
|January 31, 2024
概括
一种新的通用风险预测模型有效地评估了有或没有动脉样硬化心血管疾病 (ASCVD) 的个体的主要心血管不良事件 (MACE). 这种方法简化了初级和二级预防策略的风险分层.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 生物统计学 生物统计学
背景情况:
- 目前的指导方针建议在初级和二级心血管疾病预防方面采用单独的风险分类系统.
- 这些系统经常使用类似的预测因素,这表明可能有一个统一的方法来预测主要不良心血管事件 (MACE).
研究的目的:
- 评估有或没有现有的动脉样硬化心血管疾病 (ASCVD) 的个体的预测器性能.
- 开发和验证适用于不同ASCVD状态的MACE的通用风险预测模型.
主要方法:
- 使用Cox模型对ARIC研究中的9,138名参与者 (有或没有ASCVD) 的分析.
- 包括已确立的预测因素,体重指数和心脏生物标志物 (热素,尿酸).
- 在MESA研究中验证通用模型.
主要成果:
- 大多数预测因素都与MACEs表现出类似的关联,无论基线ASCVD状态如何.
- 通用风险预测模型表现出良好的歧视 (c-统计 0.747 和 0.691) 和两个组的优秀校准.
- 该模型确定了没有ASCVD的个体的风险高于一些ASCVD的个体,并得到了外部验证.
结论:
- 一种通用风险预测方法对于有或没有ASCVD的个体是有效的.
- 这种统一的模型可以简化风险分类,帮助初级和二级心血管预防之间的过渡.
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