两种性别差异在两个国际指南中通过冠状动脉计算机断层血管学评估症状外科患者的阻塞性冠状动脉疾病
Yahang Tan1, Zhe Wang1, Qian Xin2
1Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
欧洲心脏病学会 (ESC) 的指导方针比国家卫生和护理卓越研究所 (NICE) 的指导方针更准确地评估门诊患者的胸痛风险. 经济与社会委员会的指导方针减少了女性不必要的测试,并改善了男性的适当测试.
科学领域:
- 心脏病学 心脏病学
- 医学指导方针 医学指导方针
- 诊断测试 诊断测试 诊断测试 诊断测试
背景情况:
- 冠状动脉疾病 (CAD) 的患病率在女性中较低.
- 非侵入性检测可能对低风险个体没有好处.
- 目前评估胸痛门诊患者的指导方针因性别而异.
研究的目的:
- 将NICE和ESC指南对胸痛门诊患者的表现进行比较.
- 评估指南应用中的性别特异性差异.
- 评估冠状动脉疾病风险分层的准确性.
主要方法:
- 对542名门诊患者进行了回顾性研究,这些患者被转诊进行冠状动脉计算机断层扫描血管造影 (CCTA).
- 使用2016年NICE和2019年ESC指南进行风险评估.
- 将其分为低风险和高风险组.
- 净重新分类改进 (NRI) 用于比较指南性能.
主要成果:
- 冠状动脉疾病 (CAD) 的患病率为27%.
- 与NICE相比,ESC指南显示出更高的灵敏度,特异性和积极的预测价值.
- 与NICE相比,ESC指南显示NRI的正值为30.32%,与NICE相比.
- 经济与社会委员会的指导方针将更多的女性 (55.56%) 与男性 (28.14%) 分类为低风险.
结论:
- 与NICE指南相比,ESC指南为胸痛门诊患者提供了更准确的风险评估.
- 应用ESC指导方针可以减少女性不适当的测试.
- 欧洲社会委员会 (ESC) 的指导方针可以增加对男性进行适当的非侵入性测试.
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