预测心血管疾病风险事件 (预防) 方程:临床医生需要知道什么?
Ali Bin Abdul Jabbar1, Maha Inam2, Nausharwan Butt3
1Department of Medicine, Internal Medicine Division, Creighton University School of Medicine, Omaha, NE, USA.
Current atherosclerosis reports
|July 21, 2025
概括
新的PREVENT方程通过结合更广泛的健康因素和社会决定因素,改善了心血管疾病 (CVD) 风险评估,优于动脉样硬化心血管疾病 (ASCVD) 和心力衰竭 (HF) 预测的旧方法.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 传统的心血管疾病 (CVD) 风险计算器,如聚合队列方程 (PCE),在准确性和包容性方面存在局限性.
- 现有的模型可能会过度预测风险,并且无法充分考虑代谢,和社会因素的复杂相互作用.
研究的目的:
- 审查新的预测心血管疾病风险事件 (PREVENT) 方程的理由,发展和影响.
- 评估PREVENT在评估总心血管疾病,动脉样硬化心血管疾病 (ASCVD) 和心力衰竭 (HF) 风险方面的表现.
- 突出PREVENT在PCE方面的进步,包括整合心血管--代谢 (CKM) 综合征因素和健康的社会决定因素.
主要方法:
- 使用多样化的,当代的,现实世界的数据集开发PREVENT方程.
- 包括关键的风险因素,如体重指数 (BMI) 和估计的膜过率 (eGFR).
- 可选地包括白蛋白-肌素比率 (ACR) 和血红蛋白A1c (HbA1c) 进行增强的CKM风险评估.
- 种族作为预测因素的排除,与PCE不同.
- 整合社会贫困指数 (SDI) 以考虑健康的社会决定因素.
主要成果:
- PREVENT方程证明了准确的歧视,可以预测CVD,ASCVD和HF总风险.
- 预防解决了与PCEs相关的ASCVD风险预测的近两倍.
- 使用PREVENT的10年ASCVD风险估计明显低于使用PCE的估计.
- 预防包括CKM综合征风险因素,并允许包括健康的社会决定因素 (SDH).
结论:
- PREVENT方程式代表了个性化心血管疾病风险评估的重大进步.
- 预防通过结合更广泛的CKM风险因素和SDH来克服PCE的局限性.
- 进一步的研究和指导方针的批准对于PREVENT在减少心血管疾病负担方面的临床实施和公共卫生影响至关重要.
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Ask the patient about their primary concern and thoroughly explore all reported symptoms.
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