将阿波利波蛋白B纳入SCORE2框架:对心血管风险预测的影响
Wen Kai Wong1,2,3, Fumihiko Takeuchi1,4,5, Le Thi Phuong Thao6
1Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia.
European journal of preventive cardiology
|January 29, 2025
概括
阿波蛋白B (ApoB) 显示了与心血管风险的剂量反应关系,但具有有限的独立预测能力. 将ApoB与系统冠状动脉风险评估2 (SCORE2) 框架相结合,有助于识别心血管疾病风险较低的个体.
科学领域:
- 心血管疾病风险预测预测
- 生物标记在风险评估中的实用性
- 公共卫生和流行病学.
背景情况:
- 心血管疾病 (CVD) 仍然是全球主要的死亡原因.
- 准确的风险预测对于有效的初级预防策略至关重要.
- 像SCORE2这样的现有风险评分需要使用新型生物标志物进行评估.
研究的目的:
- 评估Apolipoprotein B (ApoB) 对系统冠状动脉风险评估2 (SCORE2) 模型的附加值.
- 确定是否整合ApoB可以提高心血管风险预测的准确性和临床效用.
- 为了评估ApoB在英国大人口队列中的预测性能.
主要方法:
- 对448,303名英国生物库参与者进行了前性队列研究.
- 分析了Apolipoprotein B (ApoB) 水平及其与心血管疾病 (CVD) 事件的关联.
- 使用值分析和模型重新校准来评估ApoB与SCORE2.2的整合.
主要成果:
- 阿波蛋白B (ApoB) 显示了与心血管疾病风险增加的剂量反应关系 (SHR:每0.2g/L增加1.13).
- 最佳的ApoB切线 (1.18μg/L) 显示了有限的独立预测性能 (AUC 0.54).
- 将ApoB集成到SCORE2中并没有显著增强模型歧视或重新分类.
结论:
- 阿波蛋白B (ApoB) 与心血管风险有显著的关联,但独立预测能力有限.
- 将ApoB与SCORE2值结合起来,有助于识别较低风险的个体,这表明它们的作用是互补的.
- 当与现有的风险分数一起使用时,ApoB可能会改进心血管风险分层.
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