Risk score for coronary heart disease (CHD-RISK) and hemodynamically significant aortic valve stenosis
Risk score for coronary heart disease (CHD-RISK) and hemodynamically significant aortic valve stenosis
复制标题
冠心病 (CHD-RISK) 和血流动力学显着性主动脉瓣狭窄的风险评分
DOI：
10.1016/j.numecd.2022.12.023
复制
发表时间：
2023-05-17
影响因子：
3.9
通讯作者：
Liao，Xinxue
中科院分区：
文献类型：
--
作者：
Christopher，Odong;Xiong，Zhenyu;Liao，Xinxue
背景和目的多项研究调查了冠心病（CHD）危险因素与主动脉瓣狭窄（AS）之间的关系。然而，有限的研究探讨了冠心病风险评分和AS之间的关系。冠心病事件风险评分（CHD-RISK）是否可用于预测AS仍不清楚。我们的目的是调查之间的关联AS和CHD-RISK.Methods和resultsWe包括4791名参与者（年龄54.6 ± 5.0岁，58.7%的妇女，81%是欧洲血统），CHD-风险估计在1990 - 1992年。参与者随后被随访至2013年12月31日。主要结局是2011 - 2013年通过多普勒超声心动图确定的血流动力学显著AS。我们使用多变量logistic回归模型来评估冠心病风险与AS之间的关系。在随访期间，确定了963例（20.1%）AS病例。在完全校正的模型中，CHD风险的每标准差（6%）增加与AS风险的OR 95% CI [1.194，95% CI 1.068至1.335，p = 0.002]相关。以冠心病风险指数<0.94%的最低五分位数为参照，分别为0.94%~2.26%、2.26%~4.83%、4.83%~9.21%和> 9.21%; 1.33（95% CI，0.99 - 1.78，p = 0.055），1.64（95% CI，1.17-2.29，p = 0.004），2.23（95% CI，1.49-3.32，p =<0.001），2.66（95% CI，1.65-4.31，p =<0.001）。CHD风险和AS在女性、年龄≥ 55岁、目前吸烟者和BMI ≥ 30 kg/m2中较高。本研究提示CHD-RISK可用于预测与CHD相似的AS风险。未来的研究需要检测，管理和建立更好的治疗策略，在这些高风险的亚组。
Background and aimMultiple studies have investigated the association between coronary heart disease (CHD) risk factors and aortic valve stenosis (AS). However, limited studies have explored the relationship between CHD risk scores and AS. Whether incident risk scores for coronary heart disease (CHD-RISK) may be applied to predict AS remains unclear. We aim to investigate the association between AS and CHD-RISK.Methods and resultsWe included 4791 participants (age 54.6 ± 5.0 yrs, 58.7% women, 81% were of European origin), and CHD-RISK was estimated in 1990–1992. The participants were then followed-up until December 31, 2013. The primary outcome was hemodynamic significant AS identified by Doppler echocardiography in 2011–2013. We used multivariate-logistic regression models to assess the associations between CHD-RISK and AS. During follow-up, 963 (20.1%) cases of AS were identified. Per-standard deviation (6%) increase in CHD-RISK was associated with OR 95% Cl [1.194, 95% CI 1.068 to 1.335, p = 0.002] risk of AS in the fully adjusted models. Results were similar when stratified by quintiles of CHD-RISK, using the lowest quintiles <0.94% of CHD-RISK as the reference, 0.94%–2.26%, 2.26%–4.83%, 4.83%–9.21%, and >9.21% were; 1.33 (95% CI, 0.99–1.78, p = 0.055), 1.64 (95% CI, 1.17–2.29, p = 0.004), 2.23 (95% CI, 1.49–3.32, p = <0.001), 2.66 (95% CI, 1.65–4.31, p = <0.001) respectively.ConclusionsCHD-RISK was associated with AS. CHD-RISK and AS were high in females, age ≥55 yrs, current smokers, and BMI ≥ 30 kg/m2. This investigation suggests CHD-RISK may be applied to forecast AS risk similar to CHD. Future studies are required to detect, manage, and establish better treatment strategies in these high-risk subgroups.