Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
JAMA Intern Med. 2013 Sep 23;173(17):1592-8. doi: 10.1001/jamainternmed.2013.8412.
Identification of structural heart disease in asymptomatic individuals could allow early disease-modifying treatment.
To examine whether echocardiographic screening in the general population improves long-term survival or reduces the risk of cardiovascular disease.
DESIGN, SETTING, AND PARTICIPANTS: We studied 6861 middle-aged participants from the population-based Tromsø Study in Norway.
Participants were randomly allocated to an echocardiographic screening group (n = 3272) or a control group (n = 3589).
Using the as-treated approach, the data were analyzed for mortality and incidence of fatal and nonfatal myocardial infarction and stroke.
During 15 follow-up years, 880 persons (26.9%) in the screening group and 989 persons (27.6%) in the control group died (hazard ratio, 0.97; 95% CI, 0.89-1.06). No significant differences between the groups were observed in the secondary outcome measures (sudden death, mortality from any heart disease, or incidence of fatal and nonfatal myocardial infarction and stroke).
Echocardiographic screening for structural and valvular heart disease in the general population provided no benefit for mortality or for the risk of myocardial infarction or stroke.
在无症状个体中识别结构性心脏病可实现早期的疾病修正治疗。
研究在一般人群中进行超声心动图筛查是否能改善长期生存或降低心血管疾病风险。
设计、地点和参与者：我们研究了来自挪威基于人群的特罗姆瑟研究的 6861 名中年参与者。
参与者被随机分配到超声心动图筛查组（n=3272）或对照组（n=3589）。
采用实际治疗方法，分析死亡率以及致命和非致命性心肌梗死和卒中的发生率。
在 15 年的随访期间，筛查组有 880 人（26.9%）和对照组有 989 人（27.6%）死亡（风险比，0.97；95%CI，0.89-1.06）。两组在次要结局测量（猝死、任何心脏病导致的死亡率或致命和非致命性心肌梗死和卒中的发生率）方面无显著差异。
对一般人群进行结构性和瓣膜性心脏病的超声心动图筛查不能改善死亡率或心肌梗死或卒中风险。
