使用高灵敏性心脏素T的患者心房动和中等风险CHA2DS2- VASc评分风险预测的改善
Christian Salbach1, Mustafa Yildirim1, Barbara Ruth Milles1
1Department of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
在心房动 (AF) 患者中,CHA2DS2- VASc评分的预测性能较差. 添加高灵敏度的心脏托洛T (hs- cTnT) 显著改善风险预测,特别是在中等风险的AF患者中.
科学领域:
- 心脏病学
- 临床风险评估
- 前庭的管理
背景情况:
- 欧洲心脏病学会的指南建议对心房患者进行风险评估.
- 像CHA2DS2-VASc这样的现有评分对不良结果的预测性能有限.
研究的目的:
- 评估CHA2DS2- VASc评分对非膜性AF患者不良终点的预测性表现.
- 评估高灵敏性心脏素T (hs-cTnT) 在改善风险预测中的增量值.
主要方法:
- 来自海德堡心房的9995名非膜性心房患者的回顾性分析 (2009-2020年).
- 计算了CHA2DS2- VASc评分,并将患者分为低风险,中等风险或高风险.
- 用hs- cTnT和不用hs- cTnT评估了中风,心肌梗塞 (MI) 或全因死亡的综合终点.
主要成果:
- CHA2DS2- VASc评分显示预测性能较差 (AUC: 0. 648),特别是在中等风险患者中 (AUC: 0. 542).
- 在中等风险患者中,使用hs- cTnT显著改善了分歧 (AUC: 0. 778).
- 在中等风险患者中没有观察到任何不良事件hs- cTnT (< 5 ng/ l).
结论:
- 将hs- cTnT添加到CHA2DS2- VASc得分中,可以提高中等风险心血管结局的预测.
- Hs- cTnT可能有助于识别可能受益于抗凝治疗的AF患者.
- Hs- cTnT还可以帮助识别低风险的AF患者,不太可能发生不良事件.
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