JASN:慢性肾脏病患者动脉粥样硬化性心血管疾病的风险预测模型

2022-02-21 MedSci原创 MedSci原创

在慢性肾脏病患者中开发的包括新的肾脏和心脏生物标志物的10年ASCVD风险预测模型,比仅使用传统危险因素开发的方程表现更好。

慢性肾脏病患者患动脉粥样硬化性心血管疾病(ASCVD)的风险很高。然而,没有在慢性肾脏病人群中开发出ASCVD风险预测模型可为临床治疗和预防提供依据。

近日,肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章,研究人员开发并验证了慢性肾脏病患者的10年ASCVD风险预测模型,其中包括来自慢性肾功能不全队列(CRIC)研究的没有自我报告心血管疾病的参与者。ASCVD被定义为首次发生经裁定的致命性和非致命性卒中心肌梗死。研究人员的模型使用了临床可用的变量和新的生物标志物。基于区分、校准和净重分类改进来评估模型性能。

在纳入分析的2604名参与者(平均年龄为55.8岁;52.0%为男性)中,252名在基线10年内发生ASCVD。与美国心脏病学会/美国心脏协会合并队列方程(受试者工作特征曲线下面积[AUC]=0.730)相比,在CRIC样本内估计系数的模型具有更高的区分度(P=0.03),实现了AUC为0.736(95%置信区间[CI]为0.649至0.826)。

研究人员使用临床可用变量开发的CRIC模型AUC为0.760(95%CI为0.678至0.851)。CRIC生物标志物富集模型的AUC为0.771(95%CI为0.674至0.853),显著高于临床模型(P=0.001)。与汇集的队列方程相比,临床和生物标志物富集模型均经过良好校准并改进了非事件的重新分类(分别为6.6%;95%CI为3.7%至9.6%和10.0%;95%CI为6.8%至13.3%)。

由此可见,在慢性肾脏病患者中开发的包括新的肾脏和心脏生物标志物的10年ASCVD风险预测模型,比仅使用传统危险因素开发的方程表现更好。

原始出处:

Joshua D. Bundy,et al.Risk Prediction Models for Atherosclerotic Cardiovascular Disease in Patients with Chronic Kidney Disease: The CRIC Study.JASN,2022.https://jasn.asnjournals.org/content/early/2022/02/09/ASN.2021060747

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    2023-03-01 ms9000001093564417 来自江西省

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    2022-09-13 chenhongpeng
  4. 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  5. 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style='color:#2F92EE;'>#风险预测#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100911, encryptionId=2c62100911a3, topicName=风险预测)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31a8064712, createdName=12498ebem21暂无昵称, createdTime=Tue Feb 22 13:32:59 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486058, encodeId=f6a11486058c8, content=<a href='/topic/show?id=6544100912f0' target=_blank style='color:#2F92EE;'>#风险预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100912, encryptionId=6544100912f0, topicName=风险预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ebc68069079, createdName=ms9203727104890838, createdTime=Tue Feb 22 13:32:59 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496399, encodeId=410d14963992f, content=<a href='/topic/show?id=43b6e358710' target=_blank style='color:#2F92EE;'>#硬化性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73587, encryptionId=43b6e358710, topicName=硬化性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8119265602, createdName=Smile2683, createdTime=Tue Feb 22 13:32:59 CST 2022, time=2022-02-22, status=1, ipAttribution=)]
    2022-05-10 a little

    慢性肾脏病

    0

  6. 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  7. 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CKD患者注射降糖药物的剂量调整有大学问!一起来围观吧!

在全世界,肾衰竭最常见的原因是糖尿病。心血管疾病是糖尿病患者发病率和死亡率的主要原因,慢性肾病进一步增加了心血管疾病的总体风险。

III期 FIND-CKD 研究正式启动,非奈利酮临床研究扩展到非糖尿病肾病患者

2021年9月20日,拜耳宣布启动 FIND-CKD 研究,这是一项多中心、随机、双盲、安慰剂对照的 III 期临床研究,考察在指南推荐疗法基础上加用非奈利酮治疗非糖尿病慢性肾病的疗效和安全性。

Neurology:10年前瞻性队列研究,慢性肾脏疾病与短暂性脑缺血发作/脑卒中前后痴呆发生无独立相关!

近日有研究人员试图确定在短暂性脑缺血或卒中前后 CKD 和所有原因的痴呆症之间的联系,研究表明CKD 与脑血管事件发生前后痴呆均无独立关系,这表明肾脏特异性机制不太可能在病因学中发挥重要作用。