Investigating the Agreement Between Cardiovascular Disease Risk Calculators Among People Diagnosed With Schizophrenia
Investigating the Agreement Between Cardiovascular Disease Risk Calculators Among People Diagnosed With Schizophrenia
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DOI：
10.3389/fpsyt.2018.00685
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发表时间：
2018-12-12
影响因子：
4.7
通讯作者：
Yung, Alison R.
中科院分区：
文献类型：
--
作者：
Berry, Alexandra;Drake, Richard J.;Yung, Alison R.
背景：与一般人群相比，被诊断患有精神分裂症的人的预期寿命要短得多，并且死于心血管疾病（CVD）的风险增加了一倍多。现有的心血管疾病风险计算器可用于检测心血管疾病预测风险升高的人群，以告知干预措施以降低风险。目的：本研究旨在比较精神分裂症患者样本中四种不同的10年预测心血管疾病风险的风险计算方法。方法：30名生活在英国大曼彻斯特的诊断为精神分裂症谱系障碍的参与者。使用四种不同的模型计算十年预测心血管风险评分：QRISK3、Framingham、PRIMROSE BMI和PRIMROSE脂质。比较风险估计和分类风险类别。结果：QRISK3鉴定出11名（39%）患者在10年内发生心血管事件的风险为10 - 10%，其中4名（14%）患者超过20%。Framingham模型确定4个（14%）超过10%，没有一个超过20%。PRIMROSE风险计算器没有发现参与者在10年内有10 - 10%的心血管事件风险。模型类型间的两两一致性相关系数为0.22 ~ 0.77。平均（+/- SD）年龄为40（+/- 10）岁，而QRISK3的平均“心脏年龄”为58（+/- 14）岁。结论：风险计算器对精神分裂症患者产生不同的预测CVD风险评分。使用一种风险计算器可能会产生与另一种不同的建议监测和治疗计划。因此，临床医生在做出治疗决定时应考虑其他与患者相关的因素，如患者的偏好和其他潜在的身体状况。
Background: People diagnosed with schizophrenia have a much reduced life expectancy compared to the general population, and a more than doubled risk of dying from cardiovascular disease (CVD). Existing CVD risk calculators can be used to detect people with an elevated predicted risk of CVD to inform interventions to reduce risk.Aims: This study aimed to compare four different risk calculators for 10-year predicted CVD risk in a sample of people with schizophrenia.Methods: Thirty participants with a diagnosis of schizophrenia spectrum disorders living within Greater Manchester, United Kingdom took part. Ten-year predicted cardiovascular risk scores were calculated using four different models: QRISK3, Framingham, PRIMROSE BMI, and PRIMROSE lipid. Risk estimates and classified risk categories were compared.Results: QRISK3 identified 11 (39%) as having > 10% risk of a CV event within 10 years, 4 (14%) of whom exceeded 20%. The Framingham model identified 4 (14%) as exceeding 10%, none of whom exceeded 20%. PRIMROSE risk calculators identified no participants as having > 10% risk of a CV event within 10 years. Pairwise concordance correlation coefficients between types of model ranged 0.22-0.77. Mean (+/- SD) age was 40 (+/- 10) years but QRISK3's mean "Heart age" was 58 (+/- 14) years.Conclusion: Risk calculators generate differing predicted CVD risk scores for patients with schizophrenia. Using one risk calculator might yield different recommended monitoring and treatment plans compared to another. Clinicians should therefore take into account other patient-related factors, such as patients' preferences and other underlying physical conditions when making treatment decisions.