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利用颈动脉超声对糖尿病患者进行低成本的预防性筛查。

Low-cost preventive screening using carotid ultrasound in patients with diabetes.

机构信息

Diabetes Research Center, Royapuram, Tamil Nadu, India.

Department of ECE, Visvesvaraya National Institute of Technology, Nagpur, India.

出版信息

Front Biosci (Landmark Ed). 2020 Mar 1;25(6):1132-1171. doi: 10.2741/4850.

DOI:10.2741/4850
PMID:32114427
Abstract

Diabetes and atherosclerosis are the predominant causes of stroke and cardiovascular disease (CVD) both in low- and high-income countries. This is due to the lack of appropriate medical care or high medical costs. Low-cost 10-year preventive screening can be used for deciding an effective therapy to reduce the effects of atherosclerosis in diabetes patients. American College of Cardiology (ACC)/American Heart Association (AHA) recommended the use of 10-year risk calculators, before advising therapy. Conventional risk calculators are suboptimal in certain groups of patients because their stratification depends on (a) current blood biomarkers and (b) clinical phenotypes, such as age, hypertension, ethnicity, and sex. The focus of this review is on risk assessment using innovative composite risk scores that use conventional blood biomarkers combined with vascular image-based phenotypes. AtheroEdge™ tool is beneficial for low-moderate to high-moderate and low-risk to high-risk patients for the current and 10-year risk assessment that outperforms conventional risk calculators. The preventive screening tool that combines the image-based phenotypes with conventional risk factors can improve the 10-year cardiovascular/stroke risk assessment.

摘要

糖尿病和动脉粥样硬化是中低收入国家和高收入国家中风和心血管疾病 (CVD) 的主要原因。这是由于缺乏适当的医疗护理或高昂的医疗费用。低成本的 10 年预防性筛查可用于确定有效的治疗方法,以减少糖尿病患者动脉粥样硬化的影响。美国心脏病学会 (ACC)/美国心脏协会 (AHA) 建议在提供治疗建议之前使用 10 年风险计算器。传统的风险计算器在某些患者群体中并不理想,因为它们的分层取决于 (a) 当前的血液生物标志物和 (b) 临床表型,如年龄、高血压、种族和性别。本综述的重点是使用创新的综合风险评分进行风险评估,该评分使用常规血液生物标志物结合基于血管的表型。AtheroEdge™工具对于当前和 10 年风险评估的中低至高和低至高风险患者都有益,其性能优于传统风险计算器。将基于图像的表型与常规风险因素相结合的预防性筛查工具可以提高 10 年心血管/中风风险评估。

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