Żurański Witold, Nowak Justyna, Danikiewicz Aleksander, Zubelewicz-Szkodzińska Barbara, Hudzik Bartosz
Third Department of Cardiology, Silesian Center for Heart Disease, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
Department of Cardiovascular Disease Prevention, Department of Metabolic Disease Prevention, Faculty of Public Health in Bytom, Medical University of Silesia, 40-055 Katowice, Poland.
J Clin Med. 2024 Nov 25;13(23):7133. doi: 10.3390/jcm13237133.
Age is a major risk factor that affects the likelihood of developing atherosclerotic cardiovascular disease (ASCVD). The anticipated 10-year ASCVD risk for nearly all individuals aged 70 years and older surpasses conventional risk thresholds. When considering treatment for risk factors, it is important to take into account ASCVD risk modifiers, such as malnutrition, polypharmacy, and comorbidities. The aim of this study was to estimate ASCVD risk in apparently healthy (without established ASCVD) elderly persons. We also evaluated several biochemical and clinical indicators to better characterize the studied population. : A total of 253 elderly individuals aged 70 years and older, who were apparently healthy and did not have established atherosclerotic cardiovascular disease (ASCVD), were enrolled in the study. The Systemic Coronary Risk Estimation 2-Older Persons (SCORE2-OP) model was utilized to assess their 10-year risk of developing ASCVD. Among the 253 participants, 41 (16.2%) were classified as high risk, while 212 (83.8%) were categorized as very high risk. No individuals had a low ASCVD risk (defined as less than 7.5%). The median 10-year risk of developing ASCVD for the study group was 23% (ranging from 17% to 32%). The number of individuals identified as very high risk increased significantly with age, with nearly all participants aged 75 years and older being considered very high risk. An age of 75 years or older is associated with a very high risk for ASCVD, supported by a C-statistic of 0.92, which reflects a positive predictive value (PPV) of 99% and a negative predictive value (NPV) of 52% ( < 0.001). Elderly individuals without established ASCVD constitute a varied group. The majority were identified as being at very high risk for ASCVD. Age and hypertension were the primary factors contributing to this risk. Furthermore, modifiers of ASCVD risk, including malnutrition, polypharmacy, and multimorbidity, were commonly observed.
年龄是影响动脉粥样硬化性心血管疾病（ASCVD）发生可能性的主要风险因素。几乎所有70岁及以上个体的预期10年ASCVD风险都超过了传统风险阈值。在考虑针对风险因素的治疗时，重要的是要考虑到ASCVD风险修正因素，如营养不良、多种药物治疗和合并症。本研究的目的是估计表面健康（无已确诊的ASCVD）的老年人的ASCVD风险。我们还评估了几种生化和临床指标，以更好地描述所研究的人群。：共有253名70岁及以上的老年人参与了本研究，他们表面健康，且未患有已确诊的动脉粥样硬化性心血管疾病（ASCVD）。采用老年人系统性冠状动脉风险评估2（SCORE2-OP）模型评估他们发生ASCVD的10年风险。在253名参与者中，41名（16.2%）被归类为高危，而212名（83.8%）被归类为极高危。没有个体的ASCVD风险较低（定义为低于7.5%）。研究组发生ASCVD的10年风险中位数为23%（范围为17%至32%）。被确定为极高危的个体数量随年龄显著增加，几乎所有75岁及以上的参与者都被视为极高危。75岁及以上的年龄与极高的ASCVD风险相关，C统计量为0.92，这反映出阳性预测值（PPV）为99%，阴性预测值（NPV）为52%（<0.001）。无已确诊ASCVD的老年人构成一个多样化的群体。大多数人被确定为ASCVD极高危。年龄和高血压是导致这种风险的主要因素。此外，常见的ASCVD风险修正因素包括营养不良、多种药物治疗和多种合并症。
