动脉样性心血管疾病患者的社会临床表型:潜伏类分析
Harun Kundi1, Kobina Hagan2, Tamer Yahya2
1Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX; Center for Outcomes Research, Houston Methodist, Houston, TX.
The American journal of cardiology
|November 4, 2024
概括
潜在类分析确定了三个动脉样硬化心血管疾病 (ASCVD) 患者亚组. 年轻的,少数群体的伴随性疾病患者面临着最高的死亡风险,突出显示了需要量身定制的ASCVD护理的需要.
科学领域:
- 心血管医学 心血管医学
- 生物统计学 生物统计学
- 公共卫生 公共卫生
背景情况:
- 动脉样性心血管疾病 (ASCVD) 影响着大量人群,但患者异质性尚未完全理解.
- 在ASCVD患者中确定不同的亚组可以改善风险分层和个性化治疗.
研究的目的:
- 通过隐性类分析 (LCA) 识别ASCVD的临床,人口和社会亚现象.
- 评估这些已识别的社会临床类别中所有原因和心血管死亡的风险.
主要方法:
- 隐性类分析 (LCA) 应用于与国家死亡率指数 (NDI) 相关的国家健康访谈调查 (NHIS) (2013-2018) 数据.
- 分析了18岁以上有ASCVD病史的参与者 (n=17,807).
- 所有原因和心血管死亡率作为主要结局.
主要成果:
- 确定了三种不同的ASCVD潜伏类:第1类 (白人,共发病率低),第2类 (老年人,男性占主导地位) 和第3类 (年轻人,少数人,共发病率高).
- 与1级相比,3级显示出所有原因死亡率的最高调整危险比率 (aHR) (2.255;95% CI: 1.931-2.633).
- 年轻人,女性,非西班牙裔黑人或西班牙裔个人具有较高的并发症负担和不良的健康社会决定因素 (SDoH) 面临着最大的死亡风险.
结论:
- 实际上,LCA揭示了ASCVD群体内的显著异质性.
- 由年龄较小,少数群体地位,高并发病率和不良SDoH特征的特定亚现象型与死亡风险大幅增加有关.
- 这些发现可以为有针对性的干预提供信息,并改善ASCVD患者的风险分类.
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