Liao Huocheng, Chen Qiuyue, Liu Lin, Zhong Sigan, Xiao Chun
Department of Cardiology, The Third People's Hospital of Huizhou and the Affiliated Hospital of Guangzhou Medical University, Huizhou City, Guangdong Province, People's Republic of China.
Int J Gen Med. 2022 Mar 5;15:2541-2548. doi: 10.2147/IJGM.S355573. eCollection 2022.
The current study was to design a cardiovascular risk score for the diagnosis of coronary heart disease (CHD) in the rural area of China and the sensitivity and specificity of this score would be assessed.
A total of 520 patients were enrolled and based on the results from coronary artery angiography, patients were divided into three groups: CHD group (coronary artery ≥50% stenosis), atherosclerosis group (coronary artery <50% stenosis) and normal groups (without stenosis). Between-group differences were evaluated and the sensitivity and specificity of cardiovascular risk score were evaluated.
Compared to the normal and atherosclerosis groups, patients in the CHD group were older, had higher body mass index, and more likely to be smoking and obese, and had dyslipidemia, hypertension and diabetes, and had higher cardiovascular risk score (4.05 ± 2.15 vs 2.94 ± 1.90 vs 2.54 ± 1.59). Patients in the CHD group were more likely to have cardiovascular risk scores ≥2 (90.2% CHD group vs 74.2% atherosclerosis group vs 76.1% normal group, P < 0.05). The area under the ROC was 0.673, with 95% confidence interval was 0.623-0.722 (P < 0.001), and the sensitivity and specificity were highest when the cardiovascular risk score was 4, indicating that the value of cardiovascular risk score of 4 was a good cutoff point for CHD diagnosis.
Using cardiovascular risk score can improve CHD diagnosis which may help to reduce health disparities between rural and urban area.
本研究旨在设计一种心血管疾病风险评分系统，用于诊断中国农村地区的冠心病（CHD），并评估该评分系统的敏感性和特异性。
共纳入520例患者，根据冠状动脉造影结果将患者分为三组：冠心病组（冠状动脉狭窄≥50%）、动脉粥样硬化组（冠状动脉狭窄<50%）和正常组（无狭窄）。评估组间差异，并评估心血管疾病风险评分的敏感性和特异性。
与正常组和动脉粥样硬化组相比，冠心病组患者年龄更大，体重指数更高，更易吸烟和肥胖，患有血脂异常、高血压和糖尿病，且心血管疾病风险评分更高（4.05±2.15 vs 2.94±1.90 vs 2.54±1.59）。冠心病组患者更易出现心血管疾病风险评分≥2（冠心病组为90.2%，动脉粥样硬化组为74.2%，正常组为76.1%，P<0.05）。ROC曲线下面积为0.673，95%置信区间为0.623 - 0.722（P<0.001），当心血管疾病风险评分为4时，敏感性和特异性最高，表明心血管疾病风险评分为4是冠心病诊断的一个良好切点。
使用心血管疾病风险评分可改善冠心病诊断，这可能有助于缩小城乡地区的健康差距。
