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Updated: Jun 14, 2025

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An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
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预防风险评分与MESA中的聚合队列方程
Brittany Saldivar Murphy1, M Sims Hershey2, Shi Huang1
1Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
JACC. Advances
|May 27, 2025
概括
新的PREVENT方程比目前的指南更准确地预测动脉样硬化心血管疾病 (ASCVD) 风险. PREVENT-ASCVD方程显示不同人群的性能有所改善,有助于更好地评估心血管风险.
科学领域:
- 心血管医学 心血管医学
- 流行病学 流行病学
- 风险预测建模风险预测建模
背景情况:
- 美国心脏协会在2023年推出了PREVENT (预测心血管疾病事件的风险) 方程.
- 这些方程旨在估计动脉样硬化心血管疾病 (ASCVD) 和心力衰竭 (HF) 的风险.
研究的目的:
- 为了比较PREVENT-ASCVD方程与当前的聚合队列方程 (PCE) 的预测性能.
- 为了评估PREVENT-HF风险算法的准确性.
主要方法:
- 使用了多民族动脉样硬化研究 (MESA) 队列的6,098个人.
- 计算的基线PCE和PREVENT预测的10年ASCVD事件百分比.
- 评估观察到的事件速率,预测观察差异,歧视 (C指数) 和校准 (MAE).
主要成果:
- 观察到的ASCVD事件 (6.0%) 与PREVENT预测 (5.7%) 比PCE (10.8%) 更接近.
- 预防-ASCVD在女性,非吸烟者,CKD阶段3/4的个体和高度社会贫困的人群中显示出更高的准确性.
- 42%的队列经历了使用PREVENT与PCE的风险重新分类到较低的类别.
- PREVENT-HF高估了HF事件的2.1% (62.6%的相对风险高估).
结论:
- 与PCE相比,PREVENT-ASCVD方程提供了更准确的ASCVD风险分层.
- 在女性,非吸烟者,功能障碍,社会剥夺和黑人个体中,PREVENT表现优越.
- 在MESA队列中,PREVENT-HF倾向于高估发生性心力衰竭的风险.
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