中老年和老年症状患者的风险因素和冠状动脉之间的相互作用
Lu Zeng1, Jun-Yi Luo1, Fen Liu2
1Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
结合冠状动脉 (CAC) 评分,年龄和风险因素,可以改善症状较大的老年人心脏和脑血管重大不良事件 (MACCE) 的预测. 这种方法为55岁以上的患者提供了更准确的前景.
科学领域:
- 心血管疾病风险分层心血管疾病风险分层.
- 医学成像和诊断 医学成像和诊断
- 老年心脏病学老年心脏病学
背景情况:
- 冠状动脉 (CAC) 的预后价值与中年和老年症状患者的风险因素负担相结合仍然不清楚.
- 准确的风险评估对于指导预防策略和治疗决策至关重要.
研究的目的:
- 评估冠状动脉 (CAC) 评分,年龄和心血管风险因素的综合预后值,以预测55岁及以上症状患者的主要心脏和脑血管不良事件 (MACCE).
- 为了确定是否整合这些因素与单个组件相比,提高预测准确性.
主要方法:
- 一项队列研究包括7432名症状患者 (年龄大于55岁),他们在2013年12月至2020年9月期间接受了冠状动脉计算机断层扫描血管造影 (CCTA).
- 冠状动脉 (CAC) 评分使用Agatston评分进行测量.
- 主要不良心脏和脑血管事件 (MACCE) 被追踪为主要结局,次要结局包括心力衰竭和全因死亡率.
主要成果:
- 较高的CAC分数,年龄较大和心血管风险因素增加与MACCE的风险更高有关.
- 与CAC>101和1个风险因素相比,CAC>101和≥4个风险因素的患者患MACCE的发病率是MACCE的1.71倍.
- 在CAC 0-10组中,MACCE发生率在75岁以上的患者中是12.65倍,而在55-65岁的患者中是12.65倍.
- 结合CAC分数,年龄和风险因素,改善了MACCE预测的准确性 (曲线下的面积[AUC]=0.614).
结论:
- 增加年龄,CAC分数和风险因子负担与55岁及以上症状患者未来MACCE风险更高有显著联系.
- 整合CAC得分,年龄和心血管风险因素,为中年和老年症状患者的结果提供了更准确的预测模型.
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