Stroke: HAVOC评分对心房颤动风险预测能力有待确定

2020-02-19 国际循环 国际循环

近期,Stroke杂志发表研究,旨在评估HAVOC评分模型在隐源性栓塞性卒中患者外部队列的使用效果。

为预测卒中发作后患者的心房颤动风险,临床提出HAVOC(即高血压、年龄、瓣膜性心脏病、外周血管疾病、肥胖、充血性心力衰竭和冠状动脉疾病)评分模型。模型的区分度良好(曲线下面积0.77),只有2.5%的HAVOC评分属于低危(即0~4分)的患者确诊新发心房颤动。近期,Stroke杂志发表研究,旨在评估HAVOC评分模型在隐源性栓塞性卒中患者外部队列的使用效果。
 
以心房颤动-栓塞性卒中数据库为基础,研究人员评估HAVOC评分用于预测新发心房颤动的判别能力、校准值、特异性、阴性预测值和准确性。根据初始出版建议,患者HAVOC评分为0~4可视为低危人群。

研究共纳入658例隐源性栓塞性卒中患者(中位年龄67岁,44%为女性),HAVOC评分中位数为2(四分位数范围3),有540例(82%)患者的HAVOC评分为0~4分,118例(18%)患者的HAVOC评分≥5分,95例患者(14.4%)确诊新发心房颤动[28.8%的患者心房颤动评分≥5分,11.3%的患者心房颤动评分为0~4分(年龄和性别调整OR=2.29;95%CI:1.37~3.82)]。低危HAVOC评分对无新发心房颤动患者的预测特异性为88.7%。此外,低危HAVOC评分的阴性预测值为85.1%,准确率78.0%,曲线下面积68.7%(95%CI:62.1%~73.3%)。
 
在研究队列中,既往报道中关于“低危HAVOC评分的隐源性栓塞性卒中患者心房颤动风险较低”这一说法没有得到证实。在临床实践作为常规措施实施之前,HAVOC评分模型需进一步评估。

原始出处:
George Ntaios, Kalliopi Perlepe, et al. External Performance of the HAVOC Score for the Prediction of New Incident Atrial Fibrillation. Stroke. Originally published12 Dec 2019

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    2020-08-07 yuandd
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    2020-02-21 sodoo
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    2020-02-19 心介

    房颤,临床上碰到很多哦

    0

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