Is Measuring Risk Marker Progression Useful for Cardiovascular Disease Prediction?
Is Measuring Risk Marker Progression Useful for Cardiovascular Disease Prediction?
复制标题
测量风险标志物进展对预测心血管疾病有用吗？
DOI：
10.1159/000517869
复制
发表时间：
2021
影响因子：
2.9
通讯作者：
Barinas-Mitchell Emma
中科院分区：
文献类型：
--
作者：
Fujiyoshi Akira;Zaid Maryam;Barinas-Mitchell Emma
关于测量颈动脉内膜中层厚度（cIMT）的进展是否比简单地利用单一基线测量值更能为未来的CVD事件提供进一步的预测信息，一直存在很大争议。相关研究已在各种环境中进行，包括观察性研究的汇总项目（一般人群[1]、糖尿病患者[2]和高风险个体[3]，见表1）。这些观察性研究中有许多（但不是全部）报告了疾病进展（定义为在2个不同时间点测量的cIMT差异）与CVD事件风险之间的零相关性。相比之下，最近发表的临床试验数据荟萃分析[4]显示cIMT进展与CVD事件风险显著相关，每年cIMT进展越小，风险越低[4]。面对这种明显的不一致，荟萃分析的作者指出，先前报告的零相关性“可以通过精确估计个体随时间推移的cIMT进展的挑战来解释”，并且关注“RCT中的患者组更适合”评估cIMT进展的价值[4]。
There has been much debate on whether measuring the progression of carotid intima-media thickness (cIMT) adds further predictive information for future CVD events than simply utilizing single baseline measures. Pertinent studies have been conducted in various settings, including pooled projects of observational studies (general populations [1], diabetics [2], and high-risk individuals [3], see Table 1). Many, but not all, of these observational studies have reported null associations between progression, defined as the difference in cIMT measured at 2 separate time points, and risk of CVD events. In contrast, a recently published meta-analysis of clinical trial data [4] showed a significant association of cIMT progression with risk of CVD events with smaller cIMT progression per year associated with lower risk [4]. In the face of this apparent inconsistency, the authors of the meta-analysis stated that the null associations previously reported “could be explained by the challenges of precisely estimating cIMT progression in individuals over time,” and that focusing “on groups of patients in RCTs is better suited” for assessing the value of cIMT progression [4].