基于绝对风险的与个性化益处的方法来确定中国人群心血管疾病的初级预防中他类药物的适用性:一项建模研究
Qiuping Liu1, Chao Gong1, Tianjing Zhou1
1Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China.
PLoS medicine
|July 22, 2025
概括
在中国,针对他类药物资格的个性化福利方法确定了与传统风险评分相比,更多的人将受益. 这种方法为个性化的心血管疾病预防策略提供了更高的精度.
科学领域:
- 预防心血管疾病预防心血管疾病
- 药物基因组学和个性化医学
- 公共卫生政策 公共卫生政策
背景情况:
- 目前的心血管疾病 (CVD) 初级预防指南通常依赖于绝对10年CVD风险得分.
- 这些得分可能无法完全捕捉使用他类药物降低低密度脂蛋白胆固醇 (LDL-C) 的好处的个体变化.
研究的目的:
- 为了比较基于绝对风险的方法与个性化益处的方法来确定中国成年人的他类药物适用性.
- 评估因果关系模型来预测降脂效应,并指导他类药物治疗决策.
主要方法:
- 对40-80岁成年人中国健康与退休长度研究 (CHRLS) 的全国代表性数据的分析.
- 使用绝对10年心血管疾病风险得分对照的他类药物适用性与结合个人绝对风险降低 (iARR) 的因果效益模型的比较.
- 在人口和个人层面 (iNNT) 估计符合条件的群体,避免的心血管疾病事件和需要治疗的数量 (NNT).
主要成果:
- 这两种方法都旨在预防类似数量的心血管疾病事件 (219万对216万).
- 个性化福利方法确定了4920万符合条件的成年人,而基于绝对风险的方法确定了5030万.
- 观察到显著的不一致性,受益方法独特地识别了860万可能受益的人,其中包括130万具有边界风险的人.
结论:
- 个性化效益方法在个人层面上为他类药物治疗选择提供了卓越的精度.
- 这种方法提高了识别患者获得最大利益的能力,这对于共享决策至关重要,特别是在资源有限的环境中.
- 该研究强调了个性化益处评估的潜力,以优化心血管疾病预防策略.
相关概念视频
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
177
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
177
Coronary Artery Disease IV: Preventive Measures
36
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
36
Atherosclerosis III: Management
36
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
36
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
122
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
122
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
878
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
878
Relative Risk
348
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
348


