在从聚合队列方程到AHA PREVENT过渡时,他类药物适用性差异
medRxiv : the preprint server for health sciences
|February 6, 2026
概括
新的AHA PREVENT (预测心血管疾病事件风险) 方程可能会改变他类药物的适用性,可能会对非西班牙裔黑人成年人产生不成比例的影响. 仔细监测对于公平实施这种心血管疾病风险评估工具至关重要.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 2023年AHA PREVENT方程准备取代2013年ACC/AHA聚合队列方程 (PCE) 进行动脉样硬化心血管疾病 (ASCVD) 风险估计.
- 这种转变对他类药物的适用性和潜在差异的实际影响仍然没有被研究.
研究的目的:
- 评估从PCE向AHA PREVENT方程的转变如何影响跨越各种风险值的他类药物的适用性.
- 分析这种转变对不同种族和种族小组内的他类药物适用性的影响.
主要方法:
- 对40至75岁没有糖尿病,严重的LDL-C或以前使用他类药物的成年人的回顾性队列分析.
- 利用了萨特健康 (2010-2024) 和NHANES (2011-2020) 的数据,估计了使用PCE和PREVENT方程的10年ASCVD风险.
- 针对NHANES数据进行加权分析,以确保其可通用性.
主要成果:
- 在Sutter Health中,6.3%的符合PREVENT-ASCVD5%门的个人将失去与PCE相比的他类药物资格,不成比例地影响非西班牙裔黑人成年人.
- 根据NHANES的数据显示,在PREVENT-ASCVD的5%门下,9.4%的整体和21.7%的非西班牙裔黑人成人患有PCE≥7.5%,失去了资格.
- 过渡重新校准了他类药物的适用性,在种族和种族群体中观察到显著的差异.
结论:
- 过渡到AHA PREVENT方程改变了他类药物的资格标准.
- 新的方程式可能会不成比例地降低非西班牙裔黑人成年人服用他类药物的资格.
- 以差异为重点的监测对于AHA PREVENT模型的公平临床应用至关重要.
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