Kirschenlohr Heide L, Griffin Julian L, Clarke Sarah C, Rhydwen Ranyl, Grace Andrew A, Schofield Peter M, Brindle Kevin M, Metcalfe James C
Department of Biochemistry, University of Cambridge, Building O, Downing Site, Tennis Court Road, Cambridge CB2 1QW, UK.
Nat Med. 2006 Jun;12(6):705-10. doi: 10.1038/nm1432. Epub 2006 May 28.
Multivariate analysis of 1H-NMR spectra of blood sera was reported previously to predict angiographically defined advanced coronary artery disease (CAD) with >90% accuracy and specificity. The analysis depended mainly on the major lipid regions of the spectra, but many variables, including gender and drug treatment, affect lipid composition and are potential confounders. We have determined the predictive power of the same methodology for angiographically defined CAD using plasma samples from groups of male patients, classified by statin treatment, who had normal coronary arteries (NCAs) or CAD. Predictions for NCA and CAD groups were only 80.3% correct for patients not treated with statins and 61.3% for treated patients, compared with random correct predictions of 50%. A confidence limit of >99% was achieved for 36.2% of predictions for untreated groups and 6.2% for treated groups. Detection of CAD by 1H-NMR with >99% confidence was therefore very weak compared with angiography.
先前有报道称,通过对血清的1H-NMR光谱进行多变量分析来预测血管造影定义的晚期冠状动脉疾病(CAD),其准确率和特异性超过90%。该分析主要依赖于光谱的主要脂质区域,但许多变量,包括性别和药物治疗,都会影响脂质组成,并且是潜在的混杂因素。我们使用来自按他汀类药物治疗分类的男性患者组的血浆样本,确定了相同方法对血管造影定义的CAD的预测能力,这些患者有正常冠状动脉(NCA)或CAD。对于未接受他汀类药物治疗的患者,NCA组和CAD组的预测正确率仅为80.3%,接受治疗的患者为61.3%,而随机正确预测率为50%。未治疗组36.2%的预测和治疗组6.2%的预测达到了>99%的置信限。因此,与血管造影相比,通过1H-NMR以>99%的置信度检测CAD的能力非常弱。