预测风险,临床前心力衰竭指标和意外心力衰竭:ARIC研究
Jelani K Grant1, Sui Zhang2, Sadiya S Khan3
1Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland, USA.
JACC. Heart failure
|October 4, 2025
概括
临床前心力衰竭 (HF) 措施在PREVENT-HF类别中确定了更高的绝对HF风险. 添加这些措施,特别是心脏生物标志物,大大提高了HF风险预测和歧视.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 生物标志物和诊断方法
背景情况:
- 预防心力衰竭 (HF) 临床前心力衰竭 (HF) 风险估计的预测效用尚未确定.
- 临床前HF测量对PREVENT-HF等现有风险评分的附加值需要进一步调查.
研究的目的:
- 评估PREVENT-HF风险估计与临床前HF之间的关联.
- 确定临床前HF指标如何与PREVENT-HF类别的绝对HF风险相关.
- 评估临床前HF措施是否能改善HF风险预测,超出PREVENT-HF得分.
主要方法:
- 对2714名没有心血管疾病的参与者进行了前性分析.
- 临床前HF通过心脏生物标志物 (NT-proBNP,hs-cTnT) 和/或异常心声回声学) 的升高来定义.
- 对HF的患病率和发病率进行了跨PREVENT-HF10年风险层的分析,包括和没有临床前HF标志物.
主要成果:
- 较高的PREVENT-HF风险与临床前HF患病率的增加有关.
- 在最高的PREVENT-HF风险类别 (≥20%) 中,在临床前HF患者中,HF发病率明显高于临床前HF患者 (51.5,而每1000人年为9.5).
- 将心脏生物标志物添加到PREVENT-HF中显著改善了风险歧视 (C统计学0.69至0.75) 和重新分类.
结论:
- 临床前的HF测量与在PREVENT-HF风险类别内的HF绝对风险升高有关.
- 结合临床前HF指标,特别是心脏生物标志物,可以提高PREVENT-HF心力衰竭得分的预测准确性.
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