The Intermountain Risk Score (including the red cell distribution width) predicts heart failure and other morbidity endpoints
The Intermountain Risk Score (including the red cell distribution width) predicts heart failure and other morbidity endpoints
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DOI：
10.1093/eurjhf/hfq115
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发表时间：
2010-11-01
影响因子：
18.2
通讯作者：
Anderson, Jeffrey L.
中科院分区：
文献类型：
--
作者：
Horne, Benjamin D.;May, Heidi T.;Anderson, Jeffrey L.
全血细胞计数（CBC）和基本代谢谱是常见的低成本血液检测，以前用于创建和验证用于预测死亡率的山间风险评分（IMRS）。死亡率是最明确的临床终点，但医疗护理更容易用于改变发病率，从而预防死亡。这项研究测试了IMRS是否与临床发病率终点相关。接受冠状动脉造影检查的患者（n = 3927）采用类似全基因组关联研究的设计进行评估。102项检验的Bonferroni校正要求p值< 4.9 x 10（-4）为显著性。第二组血管造影患者（n = 10413）被用来验证第一组患者样本的重要发现。在第一个患者样本中，IMRS预测心力衰竭（HF） （P-trend = 1.6 × 10(-26)）、冠心病（P-trend = 2.6 × 10(-11)）、心肌梗死（MI） （P-trend = 3.1 × 10(-25)）、心房颤动（P-trend = 2.5 × 10(-20)）和慢性阻塞性肺疾病（P-trend = 4.7 × 10(-4)）。更重要的是，IMRS预测HF再入院[风险比（HR) = 2.29/类，P-trend = 1.2 × 10(-6)），事件HF (HR = 1.88/类，P-trend = 0.02)，事件MI (HR = 1.56/类，P-trend = 4.7 × 10(-4))]。这些发现在第二个患者样本中得到证实。山间风险评分是死亡率的预测指标，与经常导致死亡率的发病率终点相关。需要进一步的研究来充分表征其临床应用，但其低成本的CBC和基本代谢谱组成可能使其成为初始风险估计和预防发病率和死亡率的理想选择。IMRS网络计算器可在http://intermountainhealthcare.org/IMRS免费获得。
The complete blood count (CBC) and basic metabolic profile are common, low-cost blood tests, which have previously been used to create and validate the Intermountain Risk Score (IMRS) for mortality prediction. Mortality is the most definitive clinical endpoint, but medical care is more easily applied to modify morbidity and thereby prevent death. This study tested whether IMRS is associated with clinical morbidity endpoints.Patients seen for coronary angiography (n = 3927) were evaluated using a design similar to a genome-wide association study. The Bonferroni correction for 102 tests required a P-value of < 4.9 x 10(-4) for significance. A second set of angiography patients (n = 10 413) was used to validate significant findings from the first patient sample. In the first patient sample, IMRS predicted heart failure (HF) (P-trend = 1.6 x 10(-26)), coronary disease (P-trend = 2.6 x 10(-11)), myocardial infarction (MI) (P-trend = 3.1 x 10(-25)), atrial fibrillation (P-trend = 2.5 x 10(-20)), and chronic obstructive pulmonary disease (P-trend = 4.7 x 10(-4)). Even more, IMRS predicted HF readmission [hazard ratio (HR) = 2.29/category, P-trend = 1.2 x 10(-6)), incident HF (HR = 1.88/category, P-trend = 0.02), and incident MI (HR = 1.56/category, P-trend = 4.7 x 10(-4)). These findings were verified in the second patient sample.Intermountain Risk Score, a predictor of mortality, was associated with morbidity endpoints that often lead to mortality. Further research is required to fully characterize its clinical utility, but its low-cost CBC and basic metabolic profile composition may make it ideal for initial risk estimation and prevention of morbidity and mortality. An IMRS web calculator is freely available at http://intermountainhealthcare.org/IMRS.