REGICOR 校正函数比Framingham 或 SCORE 分类法更能对接受他汀类药物治疗的西班牙高危患者进行更好的分类。

The REGICOR-calibrated function provides a better classification of high-risk patients on statin treatment in the Spanish population than the Framingham or SCORE classifications.

机构信息

Centro de Salud La Marina, Institut Català de la Salut, Barcelona, España.

出版信息

Rev Esp Cardiol. 2009 Oct;62(10):1134-40. doi: 10.1016/s1885-5857(09)73328-6.

DOI:10.1016/s1885-5857(09)73328-6

PMID:19793519

Abstract

INTRODUCTION AND OBJECTIVES

To determine which cardiovascular risk function is best for classifying high-risk individuals on statins.

METHODS

Descriptive cross-sectional study of 804 randomly selected patients aged 35-74 years. Variables studied included statin treatment, high cardiovascular risk according to Framingham-REGICOR (10-year risk >or=10%), Framingham-Wilson (10-year risk >or=20%) and SCORE (10-year risk >or=5%) functions, age, sex, cardiovascular risk factors, and total and high-density lipoprotein (HDL) cholesterol.

RESULTS

Overall, 83 patients (10.3%) were taking statins. The prevalence of hypercholesterolemia was 25.6%. When high-risk patients were compared with low- and medium-risk patients, the SCORE function only found a significant difference in HDL-cholesterol level (difference, 5.1 mg/dl; P< .001), whereas the Framingham-REGICOR and Framingham-Wilson functions showed that hypercholesterolemia was more prevalent (at 41% and 37.8%, respectively), the total cholesterol level was higher (difference, 15 mg/dl and 12.5 mg/dl, respectively), and the HDL-cholesterol level was lower (difference, 11.9 mg/ dl and 12 mg/dl, respectively; all P< .001). The percentage of patients on statins classified as high-risk by each function was 16% for Framingham-REGICOR (odds ratio [OR]=1.81; 95% confidence interval [CI], 1.01-3.27), 13.4% for Framingham-Wilson (OR=1.47; 95% CI, 0.87-2.47) and 10.6% for SCORE (OR=1.09; 95% CI, 0.50-2.37). Statin use was also significantly associated with hypertension (OR=1.89; 95% CI, 1.20-2.99) and hypercholesterolemia (OR=11.01; 95% CI, 6.55-18.53), and inversely associated with age in patients <65 years (OR=0.51; 95% CI, 0.32-0.81).

CONCLUSIONS

The Framingham-REGICOR function was better at classifying high-risk patients on statins than the Framingham-Wilson or SCORE functions. Statin use was associated with hypercholesterolemia and hypertension and inversely with age in patients <65 years.

摘要

目的

确定哪种心血管风险函数最适合对他汀类药物的高危人群进行分类。

方法

这是一项针对 804 名随机选择的 35-74 岁患者的描述性横断面研究。研究的变量包括他汀类药物治疗、根据弗雷明汉-REGICOR（10 年风险> = 10%）、弗雷明汉-威尔逊（10 年风险> = 20%）和 SCORE（10 年风险> = 5%）函数确定的高心血管风险、年龄、性别、心血管危险因素以及总胆固醇和高密度脂蛋白（HDL）胆固醇。

结果

总体而言，83 名患者（10.3%）正在服用他汀类药物。高胆固醇血症的患病率为 25.6%。当将高危患者与低危和中危患者进行比较时，SCORE 函数仅发现 HDL-胆固醇水平存在显著差异（差异为 5.1mg/dl；P<.001），而弗雷明汉-REGICOR 和弗雷明汉-威尔逊函数则显示高胆固醇血症更为普遍（分别为 41%和 37.8%），总胆固醇水平较高（差异分别为 15mg/dl 和 12.5mg/dl），HDL-胆固醇水平较低（差异分别为 11.9mg/dl 和 12mg/dl；均 P<.001）。每个函数将他汀类药物治疗的患者分类为高危的百分比为弗雷明汉-REGICOR 为 16%（比值比[OR]=1.81；95%置信区间[CI]，1.01-3.27），弗雷明汉-威尔逊为 13.4%（OR=1.47；95%CI，0.87-2.47），SCORE 为 10.6%（OR=1.09；95%CI，0.50-2.37）。他汀类药物的使用也与高血压（OR=1.89；95%CI，1.20-2.99）和高胆固醇血症（OR=11.01；95%CI，6.55-18.53）显著相关，与<65 岁患者的年龄呈负相关（OR=0.51；95%CI，0.32-0.81）。