Lee Kayoung
Department of Family Medicine, Inje University, Busan Paik Hospital, Bokjiro 75, Busan Jin-gu, Busan 633-165, South Korea.
Int J Cardiol. 2014 Sep 20;176(2):418-22. doi: 10.1016/j.ijcard.2014.07.101. Epub 2014 Aug 4.
This study examined the distribution of the 10-year risk for development of atherosclerotic cardiovascular disease (ASCVD) and coronary heart disease (CHD), and the proportion of participants eligible for lipid management, in the Korean population.
The risk was estimated using the Pooled Cohort Equations for non-Hispanic Whites and the Adult Treatment Panel (ATP) III equations. Eligibility for lipid-lowering treatment was assessed using the American College of Cardiology/American Heart Association Blood Cholesterol Guideline and the ATP III recommendation. Complex sampling design and area under the receiver operator characteristic curve (AUC) were used.
Among 7594 ASCVD-free Korean adults, aged 40-79 years, 31.3% (men, 44.1%; women, 19%) had a 10-year risk for an ASCVD event of ≥ 7.5%, and 27.1% (men, 39.4%; women, 15.2%) had a 10-year risk for a CHD event of ≥ 10%. These proportions differed according to age groups, ranging from 6.1 to 91.9% and 8.7 to 58.7% for patients in their 40s-70s, using the ASCVD and CHD risk estimations, respectively. Overall, 78.7% of individuals remain in the same risk stratum. Those eligible for lipid management included 32.8% of the participants using the ACC/AHA Guideline and 11.9% of those using the ATP III recommendation. In discriminating ASCVD, AUCs for the ASCVD risk assessment method and the CHD risk assessment method were 0.70 and 0.64, respectively (P<0.001).
The distribution of 10-year ASCVD and CHD risk was different according to the risk assessment methods.
本研究调查了韩国人群中动脉粥样硬化性心血管疾病(ASCVD)和冠心病(CHD)10年发病风险的分布情况,以及符合血脂管理条件的参与者比例。
使用非西班牙裔白人的合并队列方程和成人治疗小组(ATP)III方程来估计风险。根据美国心脏病学会/美国心脏协会血脂指南和ATP III建议评估降脂治疗的 eligibility。采用复杂抽样设计和受试者操作特征曲线下面积(AUC)。
在7594名年龄在40 - 79岁、无ASCVD的韩国成年人中,31.3%(男性为44.1%;女性为19%)发生ASCVD事件的10年风险≥7.5%,27.1%(男性为39.4%;女性为15.2%)发生CHD事件的10年风险≥10%。这些比例因年龄组而异,使用ASCVD和CHD风险估计时,40多岁至70多岁患者的比例分别为6.1%至91.9%和8.7%至58.7%。总体而言,78.7%的个体风险分层不变。符合血脂管理条件的参与者中,使用美国心脏病学会/美国心脏协会指南的占32.8%,使用ATP III建议的占11.9%。在区分ASCVD方面,ASCVD风险评估方法和CHD风险评估方法的AUC分别为0.70和(此处原文缺失数据)0.64(P<0.001)。
根据风险评估方法,10年ASCVD和CHD风险的分布有所不同。