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Eur Heart J：新的ABC卒中风险评分更有效

2016-03-05 Mechront 译 MedSci原创

卒中风险评估
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背景：心房颤动（AF）会增加卒中风险。心脏生物标志物的N末端B型利钠肽（NT-proBNP）和心肌肌钙蛋白（cTn-hs）是AF患者卒中风险的独立因素。研究者打算基于生物标志物，开发和验证一种新的风险评分，以改善AF患者卒中的预测。

方法和结果：研究纳入14701名AF患者，检测基线时生物标志物水平，中位数随访1.9年，进行新的风险评分的开发和内部验证。通过Cox回归评估生物标志物和临床变量对卒中的预测，或全身性栓塞的预测，并且每个变量会根据模型系数得到权重比例。接着研究者对1400名AF患者中位数随访3.4年，进行新的风险评分的验证。最重要的预测因素为：既往卒中/短暂性脑缺血发作史、NT-proBNP、cTn-hs和年龄，其中年龄包括在ABC（年龄、生物标志物、临床病史）卒中风险评分中。ABC卒中评分与广泛使用的CHA2DS2-VASc评分相比，在两个队列中ABC评分均具有很好的校准，以及更高的有效性（c-indices：推导队列 0.68 vs. 0.62, P < 0.001；验证队列 0.66 vs. 0.58,P < 0.001）。此外，对于几个重要的亚组进行分析后显示，ABC卒中评分始终如一地提供更高的一致性指数。


结论：ABC卒中评分为当前广泛使用的基于临床的卒中风险评分，可以为AF患者提供更好的决策支持。

原始出处：

Hijazi
Z, Lindbäck J,et al.The ABC (age, biomarkers, clinical history) stroke risk
score: a biomarker-based risk score for predicting stroke in atrial
fibrillation.Eur Heart J. 2016 Feb 25. pii: ehw054.

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    2016-11-27 cmj21wellington

    #ABC#

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    2016-03-07 仁心济世

    #卒中风险#

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    2016-03-07 zhaojie88

    #ART#

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    2016-03-07 slcumt

    #HEART#

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