Management of High-Risk Atherosclerotic Patients by Statins May Be Supported by Logistic Model of Intima-Media Thickening.
Management of High-Risk Atherosclerotic Patients by Statins May Be Supported by Logistic Model of Intima-Media Thickening.
复制标题
DOI：
10.3390/jcm10132876
复制
发表时间：
2021-06-29
影响因子：
3.9
通讯作者：
Tykarski A
中科院分区：
文献类型：
--
作者：
Formanowicz D;Krawczyk JB;Perek B;Lipski D;Tykarski A
虽然使用他汀类药物治疗动脉粥样硬化患者是无可争议的成功，但有关治疗的最佳开始时间及其强度的问题仍然悬而未决。我们在 Int 上发表的早期论文中提出了这一建议。 J.莫尔。科学。 (2019, 20) 颈动脉内膜中层厚度的增长遵循 S 形（即逻辑）曲线。在随后发表于 PLoS ONE (2020, 15) 的论文中，我们将此特征纳入动脉粥样硬化进展的逻辑控制理论模型中，并表明患者年龄和内膜中层厚度的某些组合比其他组合更适合开始治疗。在这项研究中，我们使用最新的临床数据库对我们的逻辑模型进行了新的全面校准。这使我们能够提出一种程序来推断特定患者群体开始他汀类药物治疗的最佳年龄。我们认为，他汀类药物治疗引起的 IMT 逻辑增长曲线斜率的降低在曲线最陡的地方是最有效的，由此效率意味着降低未来的 IMT 水平。对一组重病男性使用该程序，观察到 38 岁与逻辑曲线的最陡点相关，因此，这是开始他汀类药物治疗的首选时间。我们相信，检测逻辑曲线最陡的片段并开始对该片段进行他汀类药物给药是符合临床医生直觉的行动方案，并且可能支持决策过程。
While the use of statins in treating patients with atherosclerosis is an undisputed success, the questions regarding an optimal starting time for treatment and its strength remain open. We proposed in our earlier paper published in Int. J. Mol. Sci. (2019, 20) that the growth of intima-media thickness of the carotid artery follows an S-shape (i.e., logistic) curve. In our subsequent paper in PLoS ONE (2020, 15), we incorporated this feature into a logistic control-theoretic model of atherosclerosis progression and showed that some combinations of patient age and intima-media thickness are better suited than others to start treatment. In this study, we perform a new and comprehensive calibration of our logistic model using a recent clinical database. This allows us to propose a procedure for inferring an optimal age to start statin treatment for a particular group of patients. We argue that a decrease in the slope of the IMT logistic growth curve, induced by statin treatment, is most efficient where the curve is at its steepest, whereby the efficiency means lowering the future IMT levels. Using the procedure on an aggregate group of severely sick men, 38 years of age is observed to correlate with the steepest point of the logistic curve, and, thus, it is the preferred time to start statin treatment. We believe that detecting the logistic curve’s steepest fragment and commencing statin administration on that fragment are courses of action that agree with clinician intuition and may support decision-making processes.
登录
查看更多内容
影响因子：
5.7
作者：
Kablak-Ziembicka, A;Tracz, W;Konieczynska, M
通讯作者：
Konieczynska, M
影响因子：
4.6
作者：
Formanowicz D;Wanic-Kossowska M;Pawliczak E;Radom M;Formanowicz P
通讯作者：
Formanowicz P
影响因子：
5.7
作者：
van Staa, Tjeerd-Pieter;Smeeth, Liam;Gulliford, Martin
通讯作者：
Gulliford, Martin
影响因子：
3.7
作者：
Formanowicz D;Krawczyk JB
通讯作者：
Krawczyk JB
影响因子：
20.1
作者：
Herrington, William;Lacey, Ben;Lewington, Sarah
通讯作者：
Lewington, Sarah