使用DEVI和CARPREG-I评分预测患有膜心脏病的孕妇的心脏不良事件:来自MPAC注册表的外部验证研究
Gnanaraj Justin Paul1, Steaphen Anne Princy2, Surendran Anju1
1Institute of Cardiology, Rajiv Gandhi Government General Hospital, Madras Medical College, Parktown, Chennai, Tamil Nadu, India.
Journal of cardiology
|March 26, 2025
概括
两种风险工具,DEVI和CARPREG-I,有效预测怀孕妇女心脏膜疾病 (VHD) 的心脏事件. 虽然有用,但两者都需要重新校准,以提高临床环境中的准确性.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 临床风险评估临床风险评估
背景情况:
- 怀孕期间的膜心脏病 (VHD) 需要准确的风险评估.
- 现有的风险工具在日常使用之前需要在不同的临床环境中进行验证.
研究的目的:
- 验证DEVI (VHD特定工具) 和CARPREG-I用于预测VHD孕妇心脏不良事件.
- 评估这些风险分层工具的临床实用性.
主要方法:
- 来自MPAC注册表的609例VHD怀孕的前性队列研究 (2016年7月至2019年12月).
- 使用DEVI和CARPREG-I模型计算的风险.
- 通过歧视,校准和决策曲线分析评估的绩效.
主要成果:
- 在患有VHD的怀孕中,11.5%的孕妇经历了不良心脏事件.
- 德维 (AUC 0.747) 和卡普雷格-I (AUC 0.705) 显示出良好的歧视.
- DEVI倾向于高估风险,CARPREG-I倾向于低估风险;两者都表明临床效用在10-60%的概率之间.
结论:
- 德维和卡普雷格-I具有良好的分辨能力和临床实用性,用于VHD孕妇.
- 这两种模型的重新校准是必要的,以提高预测准确度.
- 这些经过验证的工具可以帮助高风险怀孕的临床决策.
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