东亚人口中的SCORE和SCORE2:一个绩效比较
JungMin Choi1, Soseul Sung2,3,4, Sue K Park3,4,5
1Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
JACC. Asia
|April 25, 2024
概括
新的心血管风险模型SCORE2和SCORE2-OP高估了东亚人的风险. 为了在这个群体中准确预测,需要进行修改,因为当前的模型表现不佳.
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:
- 系统冠状动脉风险评估2 (SCORE2) 和SCORE2-老年人 (OP) 模型是评估心血管疾病 (CVD) 风险的最新工具.
- 之前的代,SCORE和SCORE-OP已经使用,但需要在不同的群体中进行验证.
研究的目的:
- 在东亚人口中评估SCORE,SCORE-OP,SCORE2和SCORE2-OP风险预测模型的性能.
- 为了比较这些模型的准确性和校准,使用来自韩国的大量基于人口的队列.
主要方法:
- 利用了来自韩国国家健康保险服务 (NHIS) 健康查队列 (2004-2005) 324,384 名参与者的数据.
- 风险预测使用SCORE,SCORE2,SCORE-OP和SCORE2-OP模型进行计算,按年龄和性别分层.
- 对比预测的风险与观察到的心血管疾病事件在中位数9年的随访期间.
主要成果:
- 无论是SCORE/SCORE-OP还是SCORE2/SCORE2-OP模型,都在东亚队列中普遍高估了心血管疾病风险.
- SCORE/SCORE-OP低估了年轻人 (40-49岁的男性,40-59岁的女性) 的风险,在老年人群中高估了风险.
- 在所有年龄组和性别中,SCORE2/SCORE2-OP始终高估了风险,预测准确度 (C指数) 没有明显改善,而不是SCORE/SCORE-OP.
结论:
- 现有的SCORE和SCORE2风险模型显示,东亚人群的CVD风险表现不佳,并高估了CVD风险.
- 虽然SCORE2/SCORE2-OP与旧版本相比略有改善,但在这个人口群体中进行可靠的风险评估需要进行重大修改.
- 进一步的研究和重新校准对于提高这些心血管风险预测工具对东亚个体的临床实用性至关重要.
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