在应用系统性冠状动脉风险估计2时,根据看似健康的中年个体的指导方针,符合降脂治疗的资格
Ali Yari1, Peter Ueda2, Pia Lundman1
1Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 182 88 Stockholm, Sweden.
European journal of preventive cardiology
|June 6, 2024
概括
根据心血管疾病 (CVD) 风险得分,许多健康人有资格接受降脂疗法 (LLT). 相当一部分符合LLT的患者没有表现出动脉样硬化的迹象,这凸显了潜在的过度治疗问题.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 仍然是全球主要的死亡原因.
- 准确的风险分层对于有效的初级预防策略至关重要.
- 降脂疗法 (LLT) 是减少心血管疾病风险的关键干预措施.
研究的目的:
- 使用SCORE2风险方程,确定符合LLT资格的看似健康个体的比例.
- 评估在符合LLT资格的人群中亚临床动脉样硬化的患病率.
- 使用SCORE2方程与SCORE2图表来比较LLT资格.
主要方法:
- 瑞典心肺生物图像研究包括50-64岁的个人.
- 排除标准:以前的动脉样硬化心血管疾病,糖尿病或慢性病.
- 使用SCORE2方程和图表估计的10年心血管疾病风险;基于2021年ESC指南的LLT资格;由CCTA评估的冠状动脉样硬化.
主要成果:
- 在26,570名参与者中,36%的人根据SCORE2方程具有高/非常高的10年心血管疾病风险.
- 35%的总人口有资格接受LLT,99%的高风险人群超过了LDL胆固醇目标.
- 在那些有资格接受LLT的人中,38% (SCORE2方程) 到44% (SCORE2图表) 在CCTA上没有冠状动脉样硬化.
结论:
- 根据SCORE2风险评估,明显健康的个体中有很大一部分 (35%) 符合LLT的资格.
- 相当数量的符合条件的患者缺乏动脉样硬化病的客观证据,这表明可能过度治疗.
- 与SCORE2方程相比,SCORE2图表识别出更多的个人有资格接受LLT.
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