JACC:老年人心血管事件的风险标志物

2019-07-06 国际循环编辑部 国际循环

随着年龄增长,心血管风险急剧增加,导致老年人群中几乎普遍存在基于风险的他汀类药物资格。为限制过度治疗,需确定真正低风险的老年人。JACC发表的一项研究旨在发现“负”风险标志物,以识别低短期风险的冠心病和心血管疾病老年人。

随着年龄增长,心血管风险急剧增加,导致老年人群中几乎普遍存在基于风险的他汀类药物资格。为限制过度治疗,需确定真正低风险的老年人。JACC发表的一项研究旨在发现“负”风险标志物,以识别低短期风险的冠心病和心血管疾病老年人。



(图引自原文献)

研究纳入5805名BioImage参与者(平均年龄69岁;中位随访2.7年),作者评估13种候选标志物:冠状动脉钙化(CAC)评分=0,CAC≤10,无颈动脉斑块,无家族史,踝-肱指数正常,检测结果<第25百分位数(颈动脉内膜中层厚度,载脂蛋白B,半乳糖凝集素-3,高敏C-反应蛋白,脂蛋白a,N末端B型利钠肽前体和转铁蛋白),载脂蛋白A1>第75百分位数。使用患者特异性诊断似然比(DLR)和二元净重分类指数(NRI)比较负性风险标志物特性。

结果显示,CAC=0和CAC≤10是最强的负性风险标志物,冠心病的平均DLR为0.20和0.20(即风险低于传统危险因素评估的预测值约80%),心血管疾病的平均DLR分别为0.41和0.48。其次,半乳糖凝集素-3<25百分位数(DLR分别为0.44和0.43)且无颈动脉斑块(DLR分别为0.39和0.65)。其他候选标志物结果不显著。美国心脏病学学会/美国心脏协会定义的I类他汀类药物资格阈值的准确下行风险重分类最大CAC=0(NRI 0.23)和CAC≤10(NRI 0.28)。其次,半乳糖凝集素-3<25百分位数(NRI 0.14)并且无颈动脉斑块(NRI 0.08)。

研究表明,CAC=0,CAC≤10,低半乳糖凝集素-3或无颈动脉斑块的老年人具有显著的低心血管风险,这不禁使人质疑老年人群中所有治疗方法的适当性。

原始出处:
Martin BødtkerMortensen, et al. Negative Risk Markers for Cardiovascular Events in the Elderly. JACC. July 2019.

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    2019-09-12 hbwxf
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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Sep 10 20:32:02 CST 2019, time=2019-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371261, encodeId=a5c53e126160, content=老年人心血管疾病临床治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 14 20:10:47 CST 2019, time=2019-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370905, encodeId=8f923e0905d7, content=老年人心血管事件的风险标志物。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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authenticateStatus=null, createdAvatar=, createdBy=79b52561932, createdName=12565424m76暂无昵称, createdTime=Thu Jul 11 11:10:56 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369307, encodeId=3da336930eed, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 08 20:16:58 CST 2019, time=2019-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326263, encodeId=9d061326263ca, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Jul 08 01:38:00 CST 2019, time=2019-07-08, status=1, ipAttribution=)]
    2019-09-10 jyzxjiangqin

    老年人心血管疾病的治疗。

    0

  5. 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authenticateStatus=null, createdAvatar=, createdBy=79b52561932, createdName=12565424m76暂无昵称, createdTime=Thu Jul 11 11:10:56 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369307, encodeId=3da336930eed, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 08 20:16:58 CST 2019, time=2019-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326263, encodeId=9d061326263ca, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Jul 08 01:38:00 CST 2019, time=2019-07-08, status=1, ipAttribution=)]
    2019-08-14 jyzxjiangqin

    老年人心血管疾病临床治疗。

    0

  6. 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authenticateStatus=null, createdAvatar=, createdBy=79b52561932, createdName=12565424m76暂无昵称, createdTime=Thu Jul 11 11:10:56 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369307, encodeId=3da336930eed, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 08 20:16:58 CST 2019, time=2019-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326263, encodeId=9d061326263ca, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Jul 08 01:38:00 CST 2019, time=2019-07-08, status=1, ipAttribution=)]
    2019-08-07 jyzxjiangqin

    老年人心血管事件的风险标志物。

    0

  7. 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encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Jul 08 01:38:00 CST 2019, time=2019-07-08, status=1, ipAttribution=)]
    2019-07-16 jyzxjiangqin

    老年人心血管疾病的治疗。

    0

  8. 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    2019-07-11 12565424m76暂无昵称

    学习了,谢谢分享

    0

  9. 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    2019-07-08 天地飞扬

    学习

    0

  10. 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