前庭动负担的表现 对于中风风险分层的趋势
Jonathan P Piccini1, Evan J Stanelle2, Cody C Johnson3
1Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (J.P.P.).
Circulation. Arrhythmia and electrophysiology
|October 24, 2024
概括
通过可插入心脏监测器测量的心房动负担趋势,可以预测中风风险. 这些趋势提供了超越传统方法管理心房动 (AF) 的宝贵见解.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 预测分析是一种预测分析.
背景情况:
- 心房动 (AF) 显著增加中风风险,但传统的监测限制了对AF负担值的理解.
- 持续的AF负荷监测和预测算法显示了改善中风预测的前景.
- 插入式心脏监测器 (ICM) 为持续的AF负担评估提供了一个平台.
研究的目的:
- 为了评估从ICM数据中得出的时间AF负担趋势的表现,作为中风的预测因素.
- 与传统中风风险因素相比,评估AF负担趋势的增量预后值.
主要方法:
- 利用来自ICM的大型队列 (n=5013) 的非识别数据,与索赔数据联系起来.
- 计算每日AF负担,转换为简单移动平均线 (SMA),并通过比较SMA对来定义时间趋势.
- 采用分类树来预测缺血性中风和量化AF负担的意义使用启动的平均变量重要性.
主要成果:
- 先前的中风/过渡性缺血性发作是主要预测因素,其次是没有先前的AF诊断和AF负担趋势.
- 在预测中风方面,AF负担趋势显示出2.59的可变重要性.
- 结合基线特征和AF负担趋势,AUC达到0.73,特异性为0.70,相对风险为5.00.
结论:
- 来自ICM的时间AF负担趋势为中风风险预测提供了增量预后价值.
- AF负担趋势是中风风险的主要指标,可能会改善传统的风险分层方案.
- 这些发现支持将持续的AF负担监测纳入中风风险评估协议.
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