针对系统性红血性狼患者进行个性化心血管风险预测
May Y Choi1, Hongshu Guan2, Kazuki Yoshida2
1Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Rheumatology, University of Calgary, Calgary, Alberta, Canada.
Seminars in arthritis and rheumatism
|May 24, 2024
概括
一种名为SLECRISK的新工具可以改善系统性红斑狼 (SLE) 患者的心血管疾病 (CVD) 风险预测. SLECRISK比目前的方法更敏感,特别是在患有严重SLE的年轻女性中.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 流行病学 流行病学
背景情况:
- 系统性红斑狼 (SLE) 显著增加了心血管疾病 (CVD) 的风险.
- 一般人群心血管疾病预测算法低估了SLE患者的风险.
研究的目的:
- 开发和验证SLECRISK,一种新的预测工具,专门用于SLE患者的CVD风险.
- 与现有模型相比,提高SLE中心血管疾病风险评估的准确性.
主要方法:
- 利用了来自布里格姆和妇女医院SLE队列的数据,并对主要不良心血管事件 (MACE) 进行了10年的随访.
- 采用最小绝对收缩和选择操作员回归来确定SLE特定预测因子,用于考克斯回归模型.
- 与ACC/AHA聚合的队列风险方程,弗雷明汉风险得分 (FRS) 和修改的FRS (mFRS) 进行SLECRISK性能比较.
主要成果:
- 斯莱克瑞斯确定了与SLE相关的关键预测因素:SLE活性,疾病持续时间,肌素,抗dsDNA,抗RNP,狼抗凝剂,抗Ro阳性,以及低C4.
- 与ACC/AHA模型 (0.38) 相比,SLECRISK在检测中等/高10年MACE风险方面表现出更高的灵敏度 (0.74).
- 该工具确定了3.4倍的高风险患者,并显示了与FRS和mFRS相似的性能.
结论:
- 在SLE患者中,SLECRISK为预测10年MACE风险提供了增强的灵敏度.
- 该工具对于识别患有严重SLE和较少传统心血管疾病风险因素的高风险年轻女性特别有价值.
- 对于未来的研究,建议在较严重的SLE队列中进行外部验证.
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