Ann Med:荟萃分析显示CHADS2和CHA2DS2-VASc评分对非房颤患者卒中发生的诊断性良好

2016-07-11 phylis 译 MedSci原创

目的:CHA2DS2-VASc是伯明翰2009开发的CHADS2评分的延伸。在临床上当考虑房颤患者卒中发生额外的风险时,用此评分进行风险分层。然而,它在非房颤的人口中的作用是尚不清楚。本研究的目的是评估CHADS2 和CHA2DS2-VASc评分系统的准确性。方法:纳入CHADS2和CHA2DS2-VASc评分对非房颤患者卒中发生的风险分层的研究。结果: 在选出的114项研究中,最终选择了六个试验

目的:CHA2DS2-VASc是伯明翰2009开发的CHADS2评分的延伸。在临床上当考虑房颤患者卒中发生额外的风险时,用此评分进行风险分层。然而,它在非房颤的人口中的作用是尚不清楚。本研究的目的是评估CHADS2 和CHA2DS2-VASc评分系统的准确性。

方法:纳入CHADS2和CHA2DS2-VASc评分对非房颤患者卒中发生的风险分层的研究。

结果: 在选出的114项研究中,最终选择了六个试验纳入荟萃分析。CHADS2和CHA2DS2-VASc合并诊断的比值比(DOR)分别为2.86(95% CI = 1.83-4.28)和2.80(95% CI = 1.83-4.28)。CHA2DS2-VASc评分比CHADS2评分(0.920比0.768)更灵敏。然而,这两个分数显示有固有的异质性和不良的特异性。

结论:虽然有良好的诊断准确性,CHADS2和CHA2DS2-VASc评分的临床应用在预测非房颤患者卒中发生的风险仍需要进一步验证。非房颤患者应用CHADS2和CHA2DS2-VASc评分对卒中风险进行分层总的诊断准确性较好。

原始出处:

Liu FD, Shen XL, et al. Predictive role of CHADS2 and CHA2DS2-VASc scores on stroke and thromboembolism in patients without atrial fibrillation: a meta-analysis. Ann Med. 2016 May 6


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    2016-10-06 quxin068
  4. 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content=好文值得点赞!继续关注学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 11 22:05:33 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026260, encodeId=e69720262603a, content=<a href='/topic/show?id=6cbc915966c' target=_blank style='color:#2F92EE;'>#诊断性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91596, encryptionId=6cbc915966c, topicName=诊断性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=83a4244, createdName=swallow, createdTime=Tue Apr 04 13:35:00 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681314, encodeId=bbcd1681314ea, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Aug 04 17:35:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
    2017-02-05 huperzia
  5. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681314, encodeId=bbcd1681314ea, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Aug 04 17:35:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
  6. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681314, encodeId=bbcd1681314ea, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Aug 04 17:35:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
  7. 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content=好文值得点赞!继续关注学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 11 22:05:33 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026260, encodeId=e69720262603a, content=<a href='/topic/show?id=6cbc915966c' target=_blank style='color:#2F92EE;'>#诊断性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91596, encryptionId=6cbc915966c, topicName=诊断性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=83a4244, createdName=swallow, createdTime=Tue Apr 04 13:35:00 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681314, encodeId=bbcd1681314ea, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Aug 04 17:35:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
    2016-10-12 1e0ece0dm09(暂无匿称)

    谢谢分享学习

    0

  8. 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content=好文值得点赞!继续关注学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 11 22:05:33 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026260, encodeId=e69720262603a, content=<a href='/topic/show?id=6cbc915966c' target=_blank style='color:#2F92EE;'>#诊断性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91596, encryptionId=6cbc915966c, topicName=诊断性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=83a4244, createdName=swallow, createdTime=Tue Apr 04 13:35:00 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681314, encodeId=bbcd1681314ea, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Aug 04 17:35:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
    2016-10-11 ylzr123

    好文值得点赞!继续关注学习。

    0

  9. 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channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4567, encryptionId=0143456eae, topicName=CHA2DS2-VASc评分)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Mon Jan 09 10:35:00 CST 2017, time=2017-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146939, encodeId=a6681469396a, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Wed Oct 12 16:11:10 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145797, encodeId=02e6145e9780, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681314, encodeId=bbcd1681314ea, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Aug 04 17:35:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
    2017-04-04 swallow
  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681314, encodeId=bbcd1681314ea, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Aug 04 17:35:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
    2016-08-04 venlin

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目的:研究者汇集了海绵窦血管畸形(CM)自然史的研究结果,计算点估计并调查主要来源的异质性。方法:研究者检索了MEDLINE,EMBASE,和ISI Web of Science数据库中2015年5月以前发表的相关研究。研究者应用固定或随机效应模型和meta回归汇总数据。结果:共有25项研究纳入荟萃分析(共901295例患者)。出血症状定义为症状性出血和影像学显示出血。异质性来源定义为出血和再出血

JAMA Oncol:胶质母细胞瘤手术程度与生存率的相关性(Meta分析)

目的:确定GBM患者较大的EOR是否与1和2年总生存率的改善和6个月和1年无进展生存期相关。数据源:系统性搜索PubMed,CINAHL和Web of Science(1966年1月1日,2015年12月1日)。咨询专家并对文献评价后纳入更多的文章。1月15日至2015年12月1日收集文章。研究的选择:研究对象为新诊断为GBM成人患者(EOR不同),包括受试者客观完整的无进展生存期数据。排除儿科数

PLoS One:荟萃分析显示中药可治疗阿司匹林抵抗

背景:评估中草药(CHM)治疗阿司匹林抵抗(AR)的有效性和安全性。方法:系统性搜索7个电子数据库中评估CHM治疗AR的研究。两位作者独立的筛选数据,使用Cochrane风险偏倚工具评估研究的方法学的质量。采用RevMan 5.3软件进行数据分析。结果: 18个随机对照试验(RCT)涉及1460例受试者。15篇RCT报道,二磷酸腺苷(ADP)所致的血小板聚集率(PAR)降低有显著性差异,11例报道

Eur J Epidemiol:荟萃分析表明缺血性脑卒中与牙周炎相关

一些观察性研究已经表明牙周炎与脑缺血之间存在关联。本次荟萃分析旨在调查二者之间是否存在关联以及关联的强度。检索2016年3月2015日前发表在MEDLINE, EMBASE, Proceedings Web of Science以及Current Contents Connect上的研究,由两名评价者独立完成检索。纳入探究牙周炎和缺血性脑卒中的病例对照,横断面或队列研究。对纳入的研究进行质量评估。

PLoS One:荟萃分析显示年轻的类风湿关节炎患者心血管疾病的风险**

背景:类风湿性关节炎(RA)患者心血管疾病(CVD)的发病率增加。类风湿性关节炎是否增加心血管(CVD)的风险目前还不清楚,尤其是在女性和年轻的类风湿关节炎患者。在本研究中,研究者使用直接比较研究的荟萃分析,旨在分析,相对于一般人群,RA患者年龄和性别对心血管风险的影响。方法:系统性文献检索MEDLINE数据库中报告RA和一般人群对CV事件发生影响的文献,按照性别或年龄分层。应用渥太华纽卡斯尔量表

Am J Cardiol:荟萃分析显示焦虑是心血管疾病的危险因素

焦虑是否是一系列心血管疾病的危险因素目前还不清楚。研究者的目的是确定焦虑和一系列心血管疾病的相关性。搜索MEDLINE和EMBASE中包括有无焦虑受试者的队列研究,包括焦虑,担心,创伤后应激障碍、恐怖性焦虑、急性焦虑症的受试者。研究者研究焦虑与心血管死亡率,主要心血管事件(定义为心血管死亡,卒中,冠状动脉心脏疾病和心脏衰竭复合预后),卒中,冠状动脉心脏病,心脏衰竭和房颤。研究者确定了46个队列研究