心血管生物标志物的预测价值
Johannes Tobias Neumann1,2,3,4, Raphael Twerenbold1,2,3, Jessica Weimann1,2
1Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
增加心血管生物标志物,如高灵敏性心脏素I和N终端亲B型尿素,改善了动脉样硬化心血管疾病的预测,特别是老年人心力衰竭和死亡率.
科学领域:
- 心脏病学
- 预防医学
- 生物标志物研究
背景情况:
- 识别患有动脉样硬化心血管疾病 (ASCVD) 的高风险个体对于有效的初级预防策略至关重要.
- 使用已确定的风险因素来评估ASCVD风险,但需要改进风险分层.
研究的目的:
- 评估常规可用的心血管生物标志物的预后价值,再加上已确定的ASCVD风险因素.
- 评估ASCVD和相关结果的特定生物标志物的增量预测值.
主要方法:
- 分析了来自12个国家的28个基于人口的群体的个人数据.
- 测量了高灵敏度心脏 I,高灵敏度心脏 T,NT-proBNP,BNP和hs-CRP.
- 使用考克斯回归和重新分类分析评估了与发生的ASCVD,全因死亡率,心力衰竭,缺血性中风和心肌梗塞的相关性.
主要成果:
- 所有测量的生物标志物与发生的ASCVD和次要结果有显著的关联.
- 将单个生物标志物添加到已确定的风险因素中改善了风险预测 (C统计).
- 在65岁以下的个体中,hs- cTnI,NT- proBNP和hs- CRP的组合改善了10年ASCVD预测,对心力衰竭和全因死亡率的改善更大,特别是在65岁以上的个体中.
结论:
- 心血管生物标志物与心血管事件和死亡率密切相关.
- 虽然生物标志物在预测ASCVD风险方面提供了适度的改善,但它们的价值在预测心力衰竭和死亡率方面更为重要.
- 生物标志物的结合增强了风险预测模型,特别是在老年人群和特定的心血管结果中.
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