比较弗明汉风险评分、英国前瞻性糖尿病研究（UKPDS）风险引擎、日本动脉粥样硬化纵向研究现有队列合并研究（JALS-ECC）以及最大颈动脉内膜中层厚度在预测无症状2型糖尿病患者冠状动脉狭窄中的作用。
Comparison of the Framingham risk score, UK Prospective Diabetes Study (UKPDS) Risk Engine, Japanese Atherosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC) and maximum carotid intima-media thickness for predicting coronary artery stenosis in patients with asymptomatic type 2 diabetes.
作者信息
Fujihara Kazuya, Suzuki Hiroaki, Sato Akira, Ishizu Tomoko, Kodama Satoru, Heianza Yoriko, Saito Kazumi, Iwasaki Hitoshi, Kobayashi Kazuto, Yatoh Shigeru, Takahashi Akimitsu, Yahagi Naoya, Sone Hirohito, Shimano Hitoshi
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba.
出版信息
J Atheroscler Thromb. 2014;21(8):799-815. doi: 10.5551/jat.20487. Epub 2014 Apr 8.
AIMS
To compare the efficacy of Framingham Risk Score (FRS), UK Prospective Diabetes Study (UKPDS) risk engine, a risk score based on the Japanese Atherosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC), the maximum intima-media thickness (max-IMT) determined on coronary computed tomography angiography (CCTA) and their combination in asymptomatic patients with type 2 diabetes.
METHODS
A total of 116 Japanese patients with type 2 diabetes underwent CCTA. The risk of coronary heart disease was calculated according to the FRS, UKPDS and JALS-ECC. We evaluated the reclassification of coronary artery stenosis (CAS) based on the risk score categories after adding each IMT related variable.
RESULTS
Sixty-eight patients had CAS. The areas under the curves (AUCs) in the receiver operating characteristic curve analyses of FRS, UKPDS and JALS-ECC were 0.763 (95% confidence interval [CI]: 0.674-0.853), 0.785 (95% CI: 0.703-0.868) and 0.767 (95% CI: 0.681-0.853), respectively. The AUCs for FRS, UKPDS and JALS-ECC combined with the max-IMT were 0.788 (95% CI: 0.705-0.872), 0.800 (95% CI: 0.720-0.879) and 0.786 (95% CI: 0.703-0.869), respectively. Combining the max-IMT with the risk scores improved the identification of subjects with stenotic lesions, in particular, those in the first, second and third tertiles of the FRS, first and second tertiles of the UKPDS and first and second tertiles of the JALS-ECC (P=0.054, P=0.056, P=0.015, P=0.082, P=0.060, P=0.007, and P=0.080, respectively). The net reclassification improvement increased following the addition of a max-IMT of ≥ 1.9 mm (32.4% in FRS, 19.9% in UKPDS and 51.7% in JALS-ECC).
CONCLUSIONS
These data suggest that combining a risk score with the max-IMT improves the prediction of CAS in comparison with the risk score alone.
目的
比较弗明汉风险评分（FRS）、英国前瞻性糖尿病研究（UKPDS）风险评估工具、基于日本动脉粥样硬化纵向研究现有队列合并数据（JALS-ECC）的风险评分、冠状动脉计算机断层扫描血管造影（CCTA）测定的最大内膜中层厚度（max-IMT）及其组合在无症状2型糖尿病患者中预测冠心病的效能。
方法
共116例日本2型糖尿病患者接受了CCTA检查。根据FRS、UKPDS和JALS-ECC计算冠心病风险。在加入每个与IMT相关的变量后，我们基于风险评分类别评估冠状动脉狭窄（CAS）的重新分类情况。
结果
68例患者存在CAS。FRS、UKPDS和JALS-ECC在受试者工作特征曲线分析中的曲线下面积（AUC）分别为0.763（95%置信区间[CI]：0.674-0.853）、0.785（95%CI：0.703-0.868）和0.767（95%CI：0.681-0.853）。FRS、UKPDS和JALS-ECC与max-IMT联合后的AUC分别为0.788（95%CI：0.705-0.872）、0.800（95%CI：0.720-0.879）和0.786（95%CI：0.703-0.869）。将max-IMT与风险评分相结合可改善对狭窄病变患者的识别，特别是FRS第一、第二和第三三分位数、UKPDS第一和第二三分位数以及JALS-ECC第一和第二三分位数的患者（P值分别为0.054、0.056、0.015、0.082、0.060、0.007和0.080）。加入max-IMT≥1.9mm后，净重新分类改善增加（FRS为32.4%，UKPDS为19.9%，JALS-ECC为51.7%）。
结论
这些数据表明，与单独使用风险评分相比，将风险评分与max-IMT相结合可改善对CAS的预测。
Zotero 插件