Risk prediction for abdominal aortic aneurysm: One size does not necessarily fit all.
Risk prediction for abdominal aortic aneurysm: One size does not necessarily fit all.
复制标题
腹主动脉瘤的风险预测：一刀切不一定适合所有人。
DOI：
10.1007/s12350-021-02680-0
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Nguyen,PatriciaK
中科院分区：
文献类型：
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作者：
Sokol,Jan;Nguyen,PatriciaK
腹主动脉瘤（AAA）每年影响多达300万人，是美国的第十大杀手。1在AAA中，主动脉随着时间的推移逐渐扩大，直到有一天，它突然破裂。不幸的是，鉴于报告的急性破裂患者的死亡率高达81%，死亡几乎是肯定的。与缺血性心脏病（IHD）不同，它会产生胸痛来提醒患者寻求医疗帮助，AAA不会提供任何警告信号。因此，患者的识别需要医生用解剖成像来筛选那些有风险的患者。与IHD一样，AAA的诊断需要从仅仅查看管腔的大小发展到结合更先进的技术，包括分子成像，正如Gandhi等人在本期杂志2基因组信息和机器学习中所评论的那样。只有这样，我们才能为那些可能不符合当前风险分层模式的个体带来更个性化的诊断策略。早期发现将有助于实施适当的措施，如戒烟，健康的生活方式行为改变和改变疾病的药物（即他汀类药物和β受体阻滞剂），所有这些都可能延迟手术干预的需要并防止破裂。3
Affecting as many as 3 million people per year, abdominal aortic aneurysm (AAA) is the 10th leading killer in the USA. 1 In AAA, the aorta enlarges gradually over time until one day, it suddenly ruptures. Unfortunately, given reported mortality rates as high as 81% in patients who suffer acute rupture, death is almost a certainty. Unlike ischemic heart disease (IHD), which produces chest pain to alert patients to seek medical attention, AAA provides no warning signs. Thus, the identification of patients requires physicians to screen those at risk with anatomical imaging. Like IHD, the diagnosis of AAA needs to evolve from merely looking at the size of the lumen to incorporating more advanced techniques including molecular imaging, as reviewed by Gandhi et al, in this issue of the Journal, 2 genomic information, and machine learning. Only then can we bring more personalized diagnostic strategies to those individuals who may not fit the current risk stratification paradigms. Early detection will enable the implementation of appropriate measures such as smoking cessation, healthy lifestyle behavioral changes, and disease-altering medications (ie, statins and beta blockers), all of which may delay the need for surgical intervention and prevent rupture. 3