Predictors of cardiovascular events in patients with hypertension and left ventricular hypertrophy: the Losartan Intervention For Endpoint reduction in hypertension study
Predictors of cardiovascular events in patients with hypertension and left ventricular hypertrophy: the Losartan Intervention For Endpoint reduction in hypertension study
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高血压合并左心室肥厚患者心血管事件的预测因子：高血压终点降低研究的氯沙坦干预
DOI：
10.3109/08037050903460590
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发表时间：
2009
期刊：
影响因子：
1.8
通讯作者：
H. Wedel
中科院分区：
文献类型：
--
作者：
S. Kjeldsen;R. Devereux;D. Hille;P. Lyle;B. Dahlöf;S. Julius;J. Edelman;S. Snapinn;U. de Faire;F. Fyhrquist;H. Ibsen;O. Lederballe‐Pedersen;L. Lindholm;M. Nieminen;P. Omvik;S. Oparil;H. Wedel
抽象目标。我们评估了容易获得的患者特征，包括蛋白尿(不包括在传统的心血管风险评分中)，作为高血压伴左室肥厚(LVH)心血管事件的预测因子，并开发了结果的风险算法/评分。方法：研究方法。洛沙坦干预降低高血压终点(LIFE)研究比较了基于氯沙坦和基于阿替洛尔的治疗对9193名高血压和左心室肥厚患者心血管事件的影响。单变量和多变量分析确定了对主要复合终点(心血管死亡、中风和心肌梗死)及其组成部分的发展有显著影响的基线变量。多因素分析采用逐步选择的COX回归模型。风险分数是根据多变量分析中的风险因素系数得出的，使用朴素和杰克-刀程序进行内部验证，检查辨别和校准，并与弗雷明翰冠心病和其他风险分数进行比较。结果。生活风险评分显示终末点率随着五分之一的增加而增加(第一到第五个五分位数，复合终点2.8-26.7%，心血管死亡0.5-14.4%，中风1.2-11.3%，心肌梗死1.4-8.1%)，并通过调整潜在乐观偏见的杰克-刀方法得到证实。Framingham冠心病和其他风险评分高估了低风险患者的风险，低估了除心肌梗死外的高风险患者的风险。结论。许多患者的特征可以预测高血压和左心室肥厚患者的心血管事件。根据这些患者的特征(包括蛋白尿)得出的风险评分可以有力地预测结果，并可能改善高血压和左心室肥厚患者的风险评估和临床试验的计划。
Abstract Objective. We assessed readily available patient characteristics, including albuminuria (not included in traditional cardiovascular risk scores), as predictors of cardiovascular events in hypertension with left ventricular hypertrophy (LVH) and developed risk algorithms/scores for outcomes. Methods. The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study compared effects of losartan-based versus atenolol-based therapy on cardiovascular events in 9193 patients with hypertension and LVH. Univariate and multivariate analyses identified baseline variables with significant impact on development of the primary composite endpoint (cardiovascular death, stroke and myocardial infarction) and its components. Multivariate analysis used a Cox regression model with stepwise selection process. Risk scores were developed from coefficients of risk factors from the multivariate analysis, validated internally using naïve and jack-knife procedures, checked for discrimination and calibration, and compared with Framingham coronary heart disease and other risk scores. Results. LIFE risk scores showed increasing endpoint rates with increasing quintile (first to fifth quintile, composite endpoint 2.8–26.7%, cardiovascular death 0.5–14.4%, stroke 1.2–11.3%, myocardial infarction 1.4–8.1%) and were confirmed with a jack-knife approach that adjusts for potentially optimistic bias. The Framingham coronary heart disease and other risk scores overestimated risk in lower risk patients and underestimated risk in higher risk patients, except for myocardial infarction. Conclusion. A number of patient characteristics predicted cardiovascular events in patients with hypertension and LVH. Risk scores developed from these patient characteristics, including albuminuria, strongly predicted outcomes and may improve risk assessment of patients with hypertension and LVH and planning of clinical trials.
影响因子：
8.3
作者：
WOLF, PA;DAGOSTINO, RB;KANNEL, WB
通讯作者：
KANNEL, WB
影响因子：
39.2
作者：
KOREN, MJ;DEVEREUX, RB;LARAGH, JH
通讯作者：
LARAGH, JH