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评估用CKD-EPI 2021方程估计功能对ABCD-GENE评分对克洛皮多格雷尔反应预测的影响
Maryam Jamal AlSaeed1,2, Cameron D Thomas1, Francesco Franchi3
1Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Clinical pharmacology and therapeutics
|July 20, 2024
概括
新的CKD-EPI Scr 2021方程,没有种族,改变了ABCD-GENE得分来预测克洛皮多格雷尔反应. 这影响了接受皮肤冠状动脉干预 (PCI) 的患者的风险评估.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药物基因组学 药物基因组学
背景情况:
- 该ABCD-GENE得分预测了PCI后的克洛皮多格雷尔反应,包括年龄,BMI,CKD,糖尿病和CYP2C19变异.
- 目前的指导方针建议使用CKD-EPI Scr 2021方程进行不包括种族的GFR估计.
研究的目的:
- 评估CKD-EPI Scr 2021方程与2009方程对PCI后患者的ABCD-GENE得分的影响.
- 评估在GFR估计中删除种族变量如何影响克洛皮多格雷尔反应预测.
主要方法:
- 在4335名PCI后患者中,使用CKD-EPI Scr 2021和CKD-EPI 2009方程进行了GFR估计的比较.
- 根据每个GFR估计方法重新计算的ABCD-GENE得分.
- 分析了CKD患病率和患者风险分层的变化.
主要成果:
- CKD-EPI Scr 2021方程导致黑人患者的EGFR较低和CKD患病率较高,但非黑人患者的EGFR较高和CKD患病率较低.
- 这导致1%的黑人患者从低风险转为高风险,1%的非黑人患者从高风险转为低风险,因克洛皮多格雷尔反应不佳而被重新分类.
- 在两个GFR估计方程之间观察到风险预测的显著差异 (P < 0.001).
结论:
- 使用CKD-EPI Scr 2021方程从GFR估计中排除种族显著改变了ABCD-GENE得分.
- 这一变化影响了对克洛皮多格雷尔有效性和PCI后患者风险分层的预测.
- 对ABCD-GENE评分的临床应用需要考虑最新的GFR估计方法.
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