Waqanivavalagi Steve W F R
Department of Medicine, University of Auckland, Auckland, New Zealand; Adult Emergency Department at Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand; Green Lane Cardiothoracic Surgical Unit at Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand.
Curr Probl Cardiol. 2023 May;48(5):101594. doi: 10.1016/j.cpcardiol.2023.101594. Epub 2023 Jan 18.
There is increasing evidence that New Zealand has a relatively high incidence of acute aortic syndrome (AAS), which has been attributed to the disproportionately high incidence of AAS among the indigenous Māori population. There is growing interest in the use of risk-stratification tools to help clinicians determine which patients with suspected AAS should proceed to advanced imaging. The aortic dissection detection risk score has been proposed as a novel tool for excluding AAS when coupled with a serum D-dimer <500 ng/mL. However, its use in Māori has not specifically been evaluated. A review of AAS in Māori is herein undertaken with a call made for further work to clarify the outcomes and incidences in Māori. Given that Māori ethnicity is a high-risk criterion for AAS, it is recommended that, until the rule-out test is validated in Māori, clinicians have a low threshold for excluding AAS with advanced imaging.
越来越多的证据表明,新西兰急性主动脉综合征(AAS)的发病率相对较高,这被归因于原住民毛利人群中AAS的发病率过高。使用风险分层工具来帮助临床医生确定哪些疑似AAS患者应进行高级影像学检查的兴趣日益浓厚。当与血清D - 二聚体<500 ng/mL结合使用时,主动脉夹层检测风险评分已被提议作为排除AAS的一种新工具。然而,其在毛利人群中的应用尚未得到具体评估。本文对毛利人群中的AAS进行了综述,并呼吁开展进一步工作以明确毛利人群中的结局和发病率。鉴于毛利族裔是AAS的一个高风险标准,建议在该排除试验在毛利人群中得到验证之前,临床医生对通过高级影像学检查排除AAS的阈值要低。