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Circulation:复发性血管事件10年风险研究

2016-10-17 MedSci MedSci原创

临床表现的血管性疾病的患者中,其复发性血管事件的风险是不同的。我们评估了二级预防人群中的10年复发性血管事件风险的分布。我们还估计了潜在的风险减少和剩余风险。 使用SMART评分对6904例血管性疾病患者进行了心肌梗死、卒中或血管性死亡的10年风险评估。风险评分经过了18436例各种临床表现的血管疾病患者的验证,这些患者来自TNT、IDEAL、SPARCL和CAPRIE试验。通过荟萃分析评估

临床表现的血管性疾病的患者中,其复发性血管事件的风险是不同的。我们评估了二级预防人群中的10年复发性血管事件风险的分布。我们还估计了潜在的风险减少和剩余风险。

使用SMART评分对6904例血管性疾病患者进行了心肌梗死卒中或血管性死亡的10年风险评估。风险评分经过了18436例各种临床表现的血管疾病患者的验证,这些患者来自TNT、IDEAL、SPARCL和CAPRIE试验。通过荟萃分析评估指南推荐目标(收缩压、LDL胆固醇、吸烟、运动、抗凝治疗)的剩余风险。

验证结果表明SMART风险评分是合理的,但是除外10年风险过高估计的患者(>40%)。对于各种各样临床表现的血管疾病患者,中位数10年复发性血管事件的风险为17% (IQR 11-28%),具体范围从<10%(占18%的患者)到>30%(占22%的患者)。如果风险评分达到指南推荐目标,那么47%的患者的10年剩余风险将<10%,只有9%的患者其10年剩余风险将>30%(中位数 11% (IQR 7-17%))。

结果表明,血管疾病患者的10年复发性血管事件风险差异很大。如果这些患者能到指南推荐目标,那么将有近一半的患者,其10年剩余风险不到10%。这些数据表明,即使血管疾病患者得到最佳治疗,许多患者的10年复发风险高于20%,甚至高于30%。

原始出处:

Lotte Kaasenbrood,et al.Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population.Circulation.September 28, 2016

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