将预测风险与冠状动脉样硬化在冠状动脉计算机断层扫描血管学上的实际存在进行比较
Emma Playford1, Simon Stewart1, Gerard Hoyne1,2
1The University of Notre Dame Australia, Fremantle, WA, Australia.
American heart journal plus : cardiology research and practice
|January 6, 2025
概括
传统的心血管风险评分 (CVRS) 通常低估了无症状个体的冠状动脉疾病 (CAD). 较低的CVRS并不排除显著的动脉样硬化,强调需要先进的风险预测工具.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 预防医学 预防医学
背景情况:
- 关于无症状冠状动脉疾病 (CAD) 传统心血管风险评分 (CVRS) 的预测准确度的数据有限.
- 冠状动脉计算机断层扫描血管造影 (CCTA) 是诊断无症状个人CAD的一个关键工具.
研究的目的:
- 评估传统CVRS在识别CCTA检测到的无症状冠状动脉疾病 (CAD) 的预测准确度.
- 评估CVRS与CCTA发现的动脉样硬化的实际负担之间的协议.
主要方法:
- 对没有已知CAD的无症状个体进行回顾性分析,这些人接受了CCTA查.
- 使用CCTA报告的自然语言处理进行动脉样硬化评估,包括冠状动脉分数 (CACS) 和斑块负担.
- 基于CVRS (高,中等,低,零) 和动脉样硬化严重程度 (缺席,低,中等,广泛) 的个人分类.
主要成果:
- 在828人中,大量患有广泛动脉样硬化症的人具有较低的CVRS分类 (34%的男性,56%的女性).
- 在23%的男性和31%的女性中,CVRS预测了CAD,但与动脉样硬化负担的一致性很差 (科恩的卡帕:男性0.149,女性0.096).
- 低CVRS并不排除中度至广泛动脉样硬化的存在.
结论:
- 传统的CVRS在预测无症状个体冠状动脉疾病的程度方面具有有限的准确性.
- 低CVRS不应排除在无症状人群中对CAD的进一步调查.
- 开发包含额外标记的新型风险预测工具是有必要的,以提高准确性.
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