Albertini Ricardo A, Ferrer Dario G, Romagnoli Pablo A, Tinti María E, Amigone José L, Capra Raúl, Chiabrando Gustavo A
Hospital Privado Universitario de Córdoba, Naciones Unidas 346, Córdoba, Argentina.
Instituto Universitario de Ciencias Biomédicas de Córdoba, Friuli 2786, CP 5016, Córdoba, Argentina.
Int J Cardiovasc Imaging. 2017 Oct;33(10):1521-1529. doi: 10.1007/s10554-017-1152-9. Epub 2017 May 10.
The goal of our study was to use statistical analysis to try to associate cardiovascular disease (CVD) risk scores and the observed prevalence of subclinical atherosclerosis (SA) in a non-elderly adult local population. An observational cross-sectional study was carried out (143 male and 131 female) on non-elderly adults (20-59 years). CVD risk scores included Framingham Risk Scores for 10-year hard (FRS 10 H), 30-year lipid hard or CVD (FRS 30 L H or FRS 30 L CVD), 30 year-body mass index hard or CVD (FRS 30 BMI H or FRS 30 BMI CVD) and Pooled Cohort Risk Equations for either 10 years (PCE 10) or lifetime (PCE LT). The Carotid Ultrasound (CU) study was performed and the Coronary Artery Calcium (CAC) score were obtained to assess SA. The Receiving Operating Characteristic (ROC) curve analysis followed by Youden's index was used to evaluate and adjust the stratification of CVD risk scores. SA was detected in 32.4% of individuals. The risk scores that showed the biggest areas under the ROC curve were FRS 30 L (H and CVD). When the cut-off values for these CVD risk scores were adjusted, the FRS 30 L H increased the negative predictive value for the low risk group from 87.7 to 97.0% and the FRS 30 L CVD increased the positive predictive values for the high risk group from 69.7 to 85.7%. The CVD risk stratification of non-elderly adults using FRS 30 L H and FRS 30 L CVD may be a useful tool for selecting candidate patients for diagnostic imaging studies that assess their SA prevalence.
我们研究的目的是运用统计分析,尝试将心血管疾病(CVD)风险评分与非老年本地成年人群中亚临床动脉粥样硬化(SA)的观察患病率联系起来。对非老年成年人(20 - 59岁)开展了一项观察性横断面研究(143名男性和131名女性)。CVD风险评分包括10年硬性弗明汉风险评分(FRS 10 H)、30年脂质硬性或CVD风险评分(FRS 30 L H或FRS 30 L CVD)、30年体重指数硬性或CVD风险评分(FRS 30 BMI H或FRS 30 BMI CVD)以及10年(PCE 10)或终生(PCE LT)的合并队列风险方程。进行了颈动脉超声(CU)研究,并获取冠状动脉钙化(CAC)评分以评估SA。采用接受者操作特征(ROC)曲线分析及约登指数来评估和调整CVD风险评分的分层。32.4%的个体检测到SA。在ROC曲线下显示最大面积的风险评分是FRS 30 L(H和CVD)。当调整这些CVD风险评分的临界值时,FRS 30 L H将低风险组的阴性预测值从87.7%提高到97.0%,FRS 30 L CVD将高风险组的阳性预测值从69.7%提高到85.7%。使用FRS 30 L H和FRS 30 L CVD对非老年成年人进行CVD风险分层,可能是选择候选患者进行评估其SA患病率的诊断性影像学研究的有用工具。