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Eur Heart J:SCORE风险预测模型中加入运动能力,效果将更优

2016-03-05 Mechront 译 MedSci原创

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背景:SCORE风险评估系统基于已知的心血管危险因素,对看似健康的成年人进行心血管风险分层。研究目的是为了探究,运动能力能否提高SCORE整体生存期风险评估的准确性。

方法和结果:研究纳入了22878名每年在三级医疗中心进行检查的无症状成年人。所有受试者均无已知缺血性心脏病,并根据布鲁斯协议完成了最大运动负荷试验。使用评分风险评估系统评估个人所有项的心血管风险。主要终点为死亡,排除术后随访中转移癌患者。通过NRI和AUROC评估运动能力预测死亡风险的增量贡献。

研究人群平均年龄为47.4 ± 10.3岁,71.6%为男性。平均随访9.2 ± 4.1年中,发生了505例(2.21%)死亡。Kaplan-Meier生存分析表明,SCORE和低运动能力与存活率降低有关。当添加SCORE风险预测,运动能力能够更精确的进行风险分层:NRI分析显示,分类精度总体改善了56.8%,AUROC分析下,也得到了全面改善(0.782 vs. 0.766)。

结论:SCORE和运动能力是全因死亡率的独立预测因子。添加运动能力到SCORE中,可提高模型的精确性。

原始出处:

Israel A, Kivity S,et al.Use of exercise capacity to improve SCORE risk prediction
model in asymptomatic adults
.Eur Heart J. 2016 Feb 24. pii: ehw053.


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    2016-03-07 zhaojie88
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1262718, encodeId=f9971262e18f9, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356059, encodeId=7ff8135605939, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485912, encodeId=171c148591213, content=<a href='/topic/show?id=2c62100911a3' target=_blank style='color:#2F92EE;'>#风险预测#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100911, encryptionId=2c62100911a3, topicName=风险预测)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31a8064712, createdName=12498ebem21暂无昵称, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486025, encodeId=e69014860255c, content=<a href='/topic/show?id=6544100912f0' target=_blank style='color:#2F92EE;'>#风险预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100912, encryptionId=6544100912f0, topicName=风险预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ebc68069079, createdName=ms9203727104890838, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1499975, encodeId=fdf614999e598, content=<a href='/topic/show?id=a40c9421969' target=_blank style='color:#2F92EE;'>#运动能力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94219, encryptionId=a40c9421969, topicName=运动能力)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=058e9400974, createdName=xzw116, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1561984, encodeId=0d321561984bc, content=<a href='/topic/show?id=309f509e9a' target=_blank style='color:#2F92EE;'>#CORE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5097, encryptionId=309f509e9a, topicName=CORE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562358, encodeId=d3a01562358c6, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1262718, encodeId=f9971262e18f9, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356059, encodeId=7ff8135605939, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485912, encodeId=171c148591213, content=<a href='/topic/show?id=2c62100911a3' target=_blank style='color:#2F92EE;'>#风险预测#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100911, encryptionId=2c62100911a3, topicName=风险预测)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31a8064712, createdName=12498ebem21暂无昵称, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486025, encodeId=e69014860255c, content=<a href='/topic/show?id=6544100912f0' target=_blank style='color:#2F92EE;'>#风险预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100912, encryptionId=6544100912f0, topicName=风险预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ebc68069079, createdName=ms9203727104890838, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1499975, encodeId=fdf614999e598, content=<a href='/topic/show?id=a40c9421969' target=_blank style='color:#2F92EE;'>#运动能力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94219, encryptionId=a40c9421969, topicName=运动能力)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=058e9400974, createdName=xzw116, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1561984, encodeId=0d321561984bc, content=<a href='/topic/show?id=309f509e9a' target=_blank style='color:#2F92EE;'>#CORE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5097, encryptionId=309f509e9a, topicName=CORE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562358, encodeId=d3a01562358c6, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Mar 07 01:03:00 CST 2016, time=2016-03-07, status=1, ipAttribution=)]
    2016-03-07 docwu2019
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    2016-03-07 slcumt
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