Incidence of Atherosclerotic Cardiovascular Disease in Young Adults at Low Short-Term But High Long-Term Risk.
Incidence of Atherosclerotic Cardiovascular Disease in Young Adults at Low Short-Term But High Long-Term Risk.
复制标题
DOI：
10.1016/j.jacc.2022.11.051
复制
发表时间：
2023-02-21
影响因子：
24
通讯作者：
Reynolds, Kristi
中科院分区：
文献类型：
--
作者：
An, Jaejin;Zhang, Yiyi;Zhou, Hui;Zhou, Mengnan;Safford, Monika M.;Muntner, Paul;Moran, Andrew E.;Reynolds, Kristi
年轻人可能有较高的动脉粥样硬化性心血管疾病（ASCVD）的长期风险，尽管短期风险较低。在这项研究中，我们试图比较短期和长期ASCVD风险预测工具在年轻人中的表现，并评估ASCVD发病率与预测的短期和长期风险的相关性。我们纳入了2008年至2009年美国综合医疗保健系统中18至39岁的成年人，并随访至2019年。我们计算了10年和30年ASCVD预测风险，并评估了ASCVD发病率。在414,260名年轻人中，813人在中位4年（最长11年）期间发生ASCVD事件。与10年预测风险相比，30年预测风险改善了再分类（净再分类指数：16%），尽管存在相似的歧视（Harrell’s C: 0.749 vs 0.726）。总体而言，1.0%和2.2%的年轻人分别被归类为10年预测风险升高（≥7.5%）和30年预测风险升高（≥20%），1.6%的年轻人被归类为10年预测风险低（<7.5%）但30年预测风险升高。10年预测风险高的患者ASCVD发病率为每1000人年2.60 (95% CI: 1.92-3.52)， 10年预测风险低但30年预测风险高的患者ASCVD发病率为1.87 (95% CI: 1.42-2.46)， 10年和30年预测风险低的患者ASCVD发病率为0.32 （95% CI: 0.30-0.35）。年龄和性别调整后的发病率比为3.04 (95% CI: 2.25-4.10)，与10年和30年预测风险低的患者进行比较。长期ASCVD风险预测工具进一步区分了一组观察到风险升高但短期风险估计较低的年轻人。
Young adults may have high long-term atherosclerotic cardiovascular disease (ASCVD) risk despite low short-term risk. In this study, we sought to compare the performance of short-term and long-term ASCVD risk prediction tools in young adults and evaluate ASCVD incidence associated with predicted short-term and long-term risk. We included adults aged 18 to 39 years, from 2008 to 2009 in a U.S. integrated health care system, and followed them through 2019. We calculated 10-year and 30-year ASCVD predicted risk and assessed ASCVD incidence. Among 414,260 young adults, 813 had an incident ASCVD event during a median of 4 years (maximum 11 years). Compared with 10-year predicted risk, 30-year predicted risk improved reclassification (net reclassification index: 16%) despite having similar discrimination (Harrell’s C: 0.749 vs 0.726). Overall, 1.0% and 2.2% of young adults were categorized as having elevated 10-year (≥7.5%) and elevated 30-year (≥20%) predicted risk, respectively, and 1.6% as having low 10-year (<7.5%) but elevated 30-year predicted risk. The ASCVD incidence rate per 1,000 person-years was 2.60 (95% CI: 1.92–3.52) for those with elevated 10-year predicted risk, 1.87 (95% CI: 1.42–2.46) for those with low 10-year but elevated 30-year predicted risk, and 0.32 (95% CI: 0.30–0.35) for those with low 10-year and 30-year predicted risk. The age- and sex-adjusted incidence rate ratio was 3.04 (95% CI: 2.25–4.10) comparing those with low 10-year but elevated 30-year predicted risk and those with low 10-year and 30-year predicted risk. Long-term ASCVD risk prediction tools further discriminate a subgroup of young adults with elevated observed risk despite low estimated short-term risk.
登录
查看更多内容
影响因子：
5.4
作者：
Kandula NR;Kanaya AM;Liu K;Lee JY;Herrington D;Hulley SB;Persell SD;Lloyd-Jones DM;Huffman MD
通讯作者：
Huffman MD
影响因子：
24
作者：
Singh A;Collins BL;Gupta A;Fatima A;Qamar A;Biery D;Baez J;Cawley M;Klein J;Hainer J;Plutzky J;Cannon CP;Nasir K;Di Carli MF;Bhatt DL;Blankstein R
通讯作者：
Blankstein R
影响因子：
5.6
作者：
Chen, WS;Petitti, DB;Enger, S
通讯作者：
Enger, S
影响因子：
120.7
作者：
Mosley, Jonathan D.;Gupta, Deepak K.;Wang, Thomas J.
通讯作者：
Wang, Thomas J.
影响因子：
37.8
作者：
Berry JD;Liu K;Folsom AR;Lewis CE;Carr JJ;Polak JF;Shea S;Sidney S;O'Leary DH;Chan C;Lloyd-Jones DM
通讯作者：
Lloyd-Jones DM