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An R-Based Landscape Validation of a Competing Risk Model
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心血管预测风险:基于群体的聚合队列方程和PREVENT的基于人群的比较
1Hubert Department of Global Health, Rollins School of Public Health, Emory University, GA, USA.
International journal of cardiology
|August 5, 2024
概括
新的PREVENT心血管风险评分显著降低了预测的动脉样硬化心血管疾病 (ASCVD) 风险,重新分类了大多数高风险个体. 这种转变可能会影响ASCVD预防的公共卫生工作.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 动脉样性心血管疾病 (ASCVD) 风险预测对公共卫生至关重要.
- PREVENT风险分数提供了与聚合队列方程 (PCE) 相比的潜在改进.
- 实施PREVENT可能会改变美国人口中ASCVD风险分布.
研究的目的:
- 使用PCE和PREVENT来量化和描述10年预测的绝对ASCVD风险分布.
- 为了比较PCE和PREVENT分数之间的风险分层.
主要方法:
- 使用了国家健康和营养检查调查 (NHANES) 数据 (2017年 - 2020年3月).
- 考虑了复杂的调查设计,以计算平均ASCVD风险和风险组的流行率.
- 使用PCE和PREVENT计算器计算风险.
主要成果:
- 与PCE相比,PREVENT将10年ASCVD绝对风险的平均值降低了一半 (4.7%与9.1%相比).
- 高风险人口的患病率从12.5% (PCE) 降至0.4% (PREVENT).
- 93%的PCE识别的高风险个体被PREVENT重新分类为中等风险.
结论:
- 采用PREVENT可以显著降低预测ASCVD风险的平均值,并减少高风险个体.
- 这种重新分类可能意味着心血管健康的改善,但可能会导致公众健康的自满.
- 需要仔细考虑,以平衡风险评分变化与正在进行的预防策略.
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