Negative Risk Markers for Cardiovascular Risk Evaluation in Chinese Adults.
Negative Risk Markers for Cardiovascular Risk Evaluation in Chinese Adults.
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中国成人心血管风险评估的阴性风险标志物
DOI：
10.3389/fcvm.2022.800671
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发表时间：
2022
影响因子：
3.6
通讯作者：
Xu Y
中科院分区：
文献类型：
--
作者：
Bie L;Niu J;Wu S;Zheng R;Xu M;Lu J;Wang T;Zhao Z;Wang S;Lin H;Dai M;Zhang D;Chen Y;Bi Y;Wang W;Ning G;Li M;Xu Y
背景传统危险因素预测的动脉粥样硬化性心血管疾病（ASCVD）风险用于指导预防性治疗。我们的目的是调查非传统新兴风险因素（即，阴性风险标志物）可以降低预测的ASCVD风险，超过传统的风险因素。方法2010-2015年，对7,568例年龄≥ 40岁的中国成年人进行随访。阴性风险标志物包括非传统脂质、尿白蛋白与肌酸酐比、心电图（ECG），使用诊断似然比（DLR）和连续净再分类指数（NRI）评估动脉粥样硬化的测量结果，以降低整个研究人群和中度动脉粥样硬化患者的CVD风险预测值。（传统危险因素预测ASCVD风险7.5%至19.9%）或高风险（≥20%）。结果在中位4.5年的随访中，416名参与者发生了CVD事件，包括非致命性心肌梗死、非致命性中风和心血管死亡。在检查的阴性风险标志物中，脂蛋白（a）≤第10百分位数（5 mg/dL）、ECG正常和颈动脉内膜中层厚度（CIMT）≤第25百分位数（0.5 mm）提供了中度CVD风险重新分类，以及在传统CVD风险因素之上的试验前至试验后风险的下降变化，尤其是在高风险参与者中。在高危受试者中，脂蛋白（a）、ECG和CIMT的DLR分别为0.41、0.75和0.41，NRI分别为18、22和14%。结论脂蛋白（a）≤ 5 mg/dL、心电图正常、CIMT ≤ 0.5 mm可作为预测ASCVD风险的阴性非传统危险指标。
Background The atherosclerotic cardiovascular disease (ASCVD) risk predicted by traditional risk factors is used to guide preventive treatment. We aimed to investigate whether preferable levels of non-traditional emerging risk factors (i.e., negative risk markers) could downgrade the predicted ASCVD risk beyond traditional risk factors. Methods A total of 7,568 Chinese adults aged ≥ 40 years were followed up during 2010–2015. Negative risk markers including non-traditional lipids, urinary albumin-to-creatinine ratio, electrocardiogram (ECG), and measurements of atherosclerosis were evaluated using diagnostic likelihood ratio (DLR) and continuous net reclassification index (NRI) for their ability to downshift predicted CVD risk in the overall study population and in participants with intermediate (traditional risk factor predicted ASCVD risk 7.5% to 19.9%) or high risk (≥20%). Results During a median follow-up of 4.5 years, 416 participants developed CVD events including non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death. Among negative risk markers examined, lipoprotein(a) ≤ 10th percentile (5 mg/dL), normal ECG, and carotid intima-media thickness (CIMT) ≤ 25th percentile (0.5 mm) provided moderate CVD risk reclassification and downward changes in pre- to post-test risk on top of the traditional CVD risk factors, especially in high-risk participants. The DLRs were 0.41, 0.75, and 0.41, and the NRIs were 18, 22, and 14% for lipoprotein(a), ECG, and CIMT, respectively in high-risk participants. Conclusions Lipoprotein(a) ≤ 5 mg/dL, normal ECG, and CIMT ≤ 0.5 mm might be used as negative non-traditional risk markers to correctly downgrade predicted ASCVD risk in Chinese adults.
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影响因子：
8.3
作者：
Elias-Smale, Suzette E.;Kavousi, Maryam;Witteman, Jacqueline C. M.
通讯作者：
Witteman, Jacqueline C. M.
影响因子：
37.8
作者：
Blaha MJ;Cainzos-Achirica M;Greenland P;McEvoy JW;Blankstein R;Budoff MJ;Dardari Z;Sibley CT;Burke GL;Kronmal RA;Szklo M;Blumenthal RS;Nasir K
通讯作者：
Nasir K
影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
24
作者：
Jorgensen, Peter Godsk;Jensen, Jan S.;Mogelvang, Rasmus
通讯作者：
Mogelvang, Rasmus
影响因子：
39.3
作者：
Verbeek R;Hoogeveen RM;Langsted A;Stiekema LCA;Verweij SL;Hovingh GK;Wareham NJ;Khaw KT;Boekholdt SM;Nordestgaard BG;Stroes ESG
通讯作者：
Stroes ESG