Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: rationale and design of the Heinz Nixdorf RECALL Study. Risk Factors, Evaluation of Coronary Calcium and Lifestyle.
Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: rationale and design of the Heinz Nixdorf RECALL Study. Risk Factors, Evaluation of Coronary Calcium and Lifestyle.
复制标题
评估临床无症状动脉粥样硬化疾病以及预测健康中年受试者心肌梗死和心源性死亡的既定风险因素和新风险因素：Heinz Nixdorf RECALL 研究的基本原理和设计。
作者：
A. Schmermund;S. Möhlenkamp;A. Stang;D. Grönemeyer;R. Seibel;H. Hirche;K. Mann;W. Siffert;K. Lauterbach;J. Siegrist;K. Jöckel;R. Erbel
背景
鉴于心血管发病率和死亡率持续居高不下，国际社会致力于开发更精确的风险预测工具，以便针对高危人群进行预防性治疗。解剖学、临床前动脉粥样硬化疾病的直接可视化具有个体化风险区分的潜力。此外，还积极评估各种风险因素，包括动脉粥样硬化疾病活动的标志物、血栓形成风险和遗传多态性。
方法
Heinz Nixdorf RECALL（风险因素、冠状动脉钙和生活方式的评估）研究是一项基于人群的前瞻性队列研究，旨在研究现代风险分层技术对“硬”心脏事件的比较价值。它的设计和动力是为了定义与冠状动脉粥样硬化特定程度相关的相对风险，通过电子束计算机断层扫描 (EBCT) 衍生的冠状动脉钙量测量，在来自大型、高度工业化鲁尔区的未经选择的城市人口中，4200 名 45 至 75 岁的男性和女性在 5 年内发生心肌梗塞和心源性死亡。此外，还通过踝臂指数、静息心电图和负荷心电图以及颈动脉内膜中层厚度的测定来检查传统心血管危险因素、新候选危险因素和社会经济危险因素、某些遗传多态性和亚临床疾病的直接体征的预测价值。前瞻性临床风险效益和健康经济分析是该研究的固有部分。具有明确临床意义的研究结果将报告给参与者，但 EBCT 结果将被保留，直至研究结束。
结论
Heinz Nixdorf RECALL 研究将确定适当的方法来识别一般城市人口中可能从预防性治疗中获得最大益处的高风险亚组。
BACKGROUND
In view of consistently high cardiovascular morbidity and mortality rates, international efforts are aimed at developing tools for more precise risk prediction to allow preventive treatment targeted at high-risk individuals. Direct visualization of anatomic, preclinical atherosclerotic disease has the potential for individualized risk discrimination. Further, a variety of risk factors are actively evaluated, including markers of the activity of atherosclerotic disease, thrombogenic risk, and genetic polymorphisms.
METHODS
The Heinz Nixdorf RECALL (Risk Factors, Evaluation of Coronary Calcium and Lifestyle) study is a population-based, prospective cohort study of the comparative value of modern risk stratification techniques for "hard" cardiac events. It is designed and powered to define the relative risk associated with the specific extent of coronary atherosclerosis measured by means of electron-beam computed tomography (EBCT)-derived coronary calcium quantities for myocardial infarction and cardiac death in 5 years in 4200 males and females aged 45 to 75 years in an unselected urban population from the large, heavily industrialized Ruhr area. Additionally, the predictive values of conventional cardiovascular risk factors, new candidate and socioeconomic risk factors, certain genetic polymorphisms, and direct signs of subclinical disease are examined with the ankle-brachial index, resting and stress electrocardiograms, and determination of carotid artery intima-media thickness. Prospective clinical risk-benefit and health economic analyses are an inherent part of the study. Study findings with established clinical significance are reported to the participants, but the EBCT findings are withheld until the conclusion of the study.
CONCLUSIONS
The Heinz Nixdorf RECALL study will define appropriate methods for identifying high-risk subgroups in the general urban population who may derive the greatest benefit from preventive treatment.
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DOI：
10.1001/jama.1996.03540030039029
发表时间：
1996
期刊：
JAMA
影响因子：
--
作者：
S. Blair;J. Kampert;H. Kohl;C. Barlow;C. Macera;R. Paffenbarger;L. Gibbons
通讯作者：
S. Blair;J. Kampert;H. Kohl;C. Barlow;C. Macera;R. Paffenbarger;L. Gibbons
影响因子：
5
作者：
Chambless, LE;Heiss, G;Clegg, LX
通讯作者：
Clegg, LX
影响因子：
37.8
作者：
Detrano, RC;Wong, ND;Narahara, KA
通讯作者：
Narahara, KA
影响因子：
158.5
作者：
Rosamond, WD;Chambless, LE;Heiss, G
通讯作者：
Heiss, G