预测急性冠状动脉综合征患者住院死亡率的风险评分表现在中国队列中
Lin Bai1, Yi-Ming Li1, Bo-Sen Yang1
1Department of Cardiology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
ACTION风险模型在预测中国急性冠状动脉综合征 (ACS) 患者的医院死亡率方面显示出高准确性,但其校准需要改进. 格雷斯模型仍然是ACS风险评估的最佳校准选项.
科学领域:
- 心脏病学 心脏病学
- 临床风险预测预测
- 公共卫生 公共卫生
背景情况:
- 急性冠状动脉综合征 (ACS) 患者的预后有很大的差异.
- 准确的风险分层对于管理高风险ACS患者至关重要.
- 像GRACE这样的现有模型被广泛使用,但对特定人群的验证是必不可少的.
研究的目的:
- 验证和比较几种风险评估模型在中国人口中对ACS的性能.
- 将ACTION和CPACS模型的临床实用性与已建立的GRACE模型进行评估.
主要方法:
- 对19237名接受冠状动脉血管造影或干预的ACS患者 (2011-2020) 的回顾性分析.
- 评估住院死亡率作为主要终点.
- 对GRACE,GRACE 2.0,ACTION,TIMI和CPACS风险模型的歧视和校准进行比较.
主要成果:
- 行动模型显示了最高的歧视 (c指数为0.945),但有不满意的校准.
- 在所有患者中,GRACE模型表现出最准确的校准.
- 为中国患者开发的CPACS模型在预测性能方面没有超过GRACE模型.
结论:
- 虽然ACTION在预测风险方面表现出色,但其校准问题限制了它在中国ACS患者中的实用性.
- 在这个队列中,GRACE模型提供了可靠的风险评估,在这个队列中具有优异的校准.
- 为了在中国优化ACS患者管理,需要进一步完善风险模型.
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