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在哥伦比亚人群队列中对 ACC/AHA ASCVD 风险评分进行外部验证。

External validation of the ACC/AHA ASCVD risk score in a Colombian population cohort.

机构信息

Critical Care Section, Internal Medicine Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia.

Internal Medicine Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia.

出版信息

Sci Rep. 2023 Apr 15;13(1):6139. doi: 10.1038/s41598-023-32668-4.

DOI:10.1038/s41598-023-32668-4
PMID:37061603
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10105759/
Abstract

No cardiovascular risk score has included Latin American patients in its development. The ACC/AHA ASCVD risk score has not been validated in Latin America; consequently, its predictive capacity in the population of the region is unknown. The aim of this study is to evaluate the discrimination capacity and calibration of the ACC/AHA ASCVD score to predict the 10-year risk of a cardiovascular event in a primary prevention cohort followed in a Colombian hospital. A retrospective cohort study was conducted in primary prevention patients belonging to an intermediate/high-risk and low-risk cohort without established atherosclerotic disease. Cardiovascular risk was calculated at inclusion. The calibration was analyzed by comparing observed and expected events in the different risk categories. A discrimination analysis was made using the area under the ROC curve and C statistic. A total of 918 patients were included-202 from the intermediate/high-risk and 716 from the low-risk cohort. The median cardiovascular risk was 3.6% (IQR 1.7-8.5%). At the 10-year follow-up, 40 events (4,4%) occurred. The area under the ROC curve was 0.782 (95% CI 0.71-0.85). The Hosmer-Lemeshow test did not show differences between expected and observed events. The ACC/AHA ASCVD score is calibrated and has good discrimination capacity in predicting 10-year risk of cardiovascular events in a Colombian population.

摘要

尚无心血管风险评分将拉丁美洲患者纳入其开发过程中。ACC/AHA ASCVD 风险评分尚未在拉丁美洲得到验证;因此,其在该地区人群中的预测能力尚不清楚。本研究旨在评估 ACC/AHA ASCVD 评分在预测哥伦比亚医院随访的一级预防队列中发生心血管事件的 10 年风险方面的区分能力和校准能力。对属于中/高危和低危队列的一级预防患者进行了回顾性队列研究,这些患者无已确立的动脉粥样硬化疾病。在纳入时计算心血管风险。通过比较不同风险类别的观察到的和预期的事件来分析校准。使用 ROC 曲线下面积和 C 统计进行区分分析。共纳入 918 例患者-202 例来自中/高危队列,716 例来自低危队列。心血管风险中位数为 3.6%(IQR 1.7-8.5%)。在 10 年随访期间,发生了 40 起事件(4.4%)。ROC 曲线下面积为 0.782(95%CI 0.71-0.85)。Hosmer-Lemeshow 检验显示预期事件与观察事件之间无差异。ACC/AHA ASCVD 评分在预测哥伦比亚人群中 10 年心血管事件风险方面具有校准能力和良好的区分能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/49fe7bbcf9e7/41598_2023_32668_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/242be6afae70/41598_2023_32668_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/c1d29ee90bce/41598_2023_32668_Fig2_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/1d866251cd8e/41598_2023_32668_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/f0c671c3a2d5/41598_2023_32668_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/49fe7bbcf9e7/41598_2023_32668_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/242be6afae70/41598_2023_32668_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/c1d29ee90bce/41598_2023_32668_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/6e666c7e6af2/41598_2023_32668_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/1d866251cd8e/41598_2023_32668_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/f0c671c3a2d5/41598_2023_32668_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf36/10105759/49fe7bbcf9e7/41598_2023_32668_Fig6_HTML.jpg

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