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聚合队列方程和PREVENTTM风险计算器对他类药物治疗分配的比较
Joseph Heaton1, Abbas Alshami2, Steven Imburgio1
1Jersey Shore University Medical Center, Department of Medicine, 1945 NJ-33, Neptune City, NJ, 07753, USA.
Atherosclerosis
|October 24, 2024
概括
预防方程是评估心血管风险的新工具,与较旧的聚合队列方程 (PCE) 有显著差异. 这项研究表明,PREVENT会改变许多患者的高胆固醇血症管理,影响他类药物治疗建议.
科学领域:
- 评估心血管疾病风险评估
- 高胆固醇血症的管理管理.
- 预防性心脏病学 预防性心脏病学
背景情况:
- 有效的高胆固醇血症管理可以降低死亡率.
- 2018年AHA/ACC聚合队列方程 (PCE) 可能高估了心血管风险,对某些种族群体来说不那么准确.
- 新的AHA PREVENT方程式省略了种族,并包括心脏代谢因素,以便在不同人群中进行潜在更准确的风险评估.
研究的目的:
- 评估高胆固醇血管理中的潜在变化,以进行初级预防.
- 为了比较PREVENT方程与PCE在全国代表性的美国人口中的应用.
- 评估风险分层和他类药物治疗指示的变化.
主要方法:
- 对大流行前的NHANES 2017-2020数据进行分析.
- 包括40至75岁的参与者,没有先前的降脂治疗.
- 风险评估使用PCE和PREVENT方程 (≥7.5%升高的风险值),然后对结果和他类药物治疗指示进行比较.
主要成果:
- 81.0%的参与者在两个方程之间没有发生风险评估变化.
- 通过PREVENT不识别的高风险参与者中,PCE确定了18.8%;PREVENT仅确定了PCE不识别的0.20%.
- 在74.59%的病例中,PCE识别的中度强度治疗候选人被重新分类为没有治疗;在93.97%的病例中,高强度候选人被重新分类为中度治疗.
结论:
- 在确定高胆固醇血症管理的个体方面,PREVENT方程与PCE显著不同.
- 采用PREVENT方程将改变心血管风险降低治疗建议.
- 需要进一步的综合性研究来了解PREVENT的长期影响,并重新评估治疗值.
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