Faculty of Kinesiology & Recreation Management, Health, Leisure & Human Performance Research Institute, University of Manitoba, Winnipeg, Manitoba, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada.
Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada; Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
Exp Gerontol. 2019 May;119:40-44. doi: 10.1016/j.exger.2019.01.021. Epub 2019 Jan 23.
Standardizing the Fried criteria (S-FC) using cutoffs specific to the patient population improves adverse outcome prediction. However, there is limited evidence to determine if a S-FC assessment can improve discrimination of cardiovascular disease (CVD) risk in middle-aged and older women.
The objective of this cross-sectional analysis was to compare the ability of the Fried frailty phenotype criteria (FC) to discriminate between individuals at higher risk for CVD according to the Framingham Risk Score and Rasmussen Disease Score in comparison to the S-FC.
Asper Clinical Research Institute, St. Boniface Hospital Research Centre.
985 women 55 years of age or older with no previous history of CVD.
Discrimination of individuals with high CVD risk according to the Framingham and Rasmussen Disease scores was assessed using receiver operating characteristic (ROC) curves, integrated discrimination index (IDI) and net reclassification index (NRI).
The S-FC showed superior ability to discriminate CVD risk as assessed by area under the ROC curve (AUROC) based on the Framingham (0.728 vs 0.634, p < 0.001), but not for the Rasmussen (0.594 vs 0.552, p = 0.079) risk score. Net reclassification index identified improved discrimination for both the Framingham (67.9%, p < 0.001) and Rasmussen Disease scores (26.0%, p = 0.003). Integrated discrimination index also identified improved CVD risk discrimination with the Framingham (3.0%, p < 0.001) and Rasmussen Disease scores (1.5%, p < 0.001).
In this study, the Fried frailty phenotype better discriminated cardiovascular disease risk when standardized to the study population.
使用特定于患者人群的截止值来标准化 Fried 标准（S-FC）可以提高不良结局预测的准确性。然而，目前尚无足够证据确定 S-FC 评估是否可以改善中年及以上女性的心血管疾病（CVD）风险的区分能力。
本横断面分析的目的是比较 Fried 衰弱表型标准（FC）与 S-FC 对Framingham 风险评分和 Rasmussen 疾病评分较高的 CVD 风险个体的区分能力。
Asper 临床研究所，圣博尼费斯医院研究中心。
985 名年龄在 55 岁或以上且无 CVD 既往史的女性。
使用接受者操作特征（ROC）曲线、综合判别指数（IDI）和净重新分类指数（NRI）评估根据Framingham 和 Rasmussen 疾病评分判断的个体 CVD 高风险的判别能力。
S-FC 显示出优于 CVD 风险的判别能力，ROC 曲线下面积（AUROC）基于 Framingham（0.728 比 0.634，p<0.001），但不基于 Rasmussen（0.594 比 0.552，p=0.079）风险评分。净重新分类指数确定 Framingham（67.9%，p<0.001）和 Rasmussen 疾病评分（26.0%，p=0.003）的判别能力得到改善。综合判别指数还确定 Framingham（3.0%，p<0.001）和 Rasmussen 疾病评分（1.5%，p<0.001）的 CVD 风险判别能力得到改善。
在这项研究中，与研究人群标准化的 Fried 衰弱表型对心血管疾病风险的判别能力更好。
