估计的脉搏波传导速度判断心血管风险与预后的可行性与实践
Feasibility and Practice of Assessing Cardiovascular Risk and Prognosis Through Estimated Pulse Wave Velocity
张丽杰 1周喆 2张建宁 2丘雨旻 2刘张弛 2徐诗岳 2王妍 2陶军2
作者信息
- 1. 珠海市妇幼保健院,广东 珠海 519000
- 2. 中山大学附属第一医院高血压血管病科,广东 广州 518100
- 折叠
摘要
目的 评估估计的脉搏波传导速度(ePWV)预测心血管风险与预后的可行性及其临床应用.方法 分析了 1999-2018年美国国家健康和营养调查数据,通过收集心血管危险因素与弗雷明汉风险评分(FRS)计算,分别使用全因死亡和心血管死亡事件作为结局指标进行Cox分析,以判断ePWV是否与临床预后独立相关.此外,使用Harrell's C统计量以判断ePWV能否为心血管风险因素或FRS模型提供额外的预后预测价值.结果 ePWV与临床结局之间的关系独立于心血管风险因素(全因死亡风险:HR=1.33,95％CI 1.21～1.50;心血管死亡风险:HR=1.51,95％CI 1.30～1.78)和 FRS 模型(全因死亡风险:HR=1.22,95％CI 1.12～1.32;心血管死亡风险:HR=1.32,95％CI 1.10～1.59).在预测价值方面,添加ePWV后预测模型的Harrell's C统计量高于仅使用心血管风险因素或FRS的模型(P＜0.05).结论 ePWV可以作为一种无创、便捷、实用评价心血管风险与预后的临床参数.
Abstract
Objective Assessing the feasibility of estimated pulse wave velocity(ePWV)in predicting cardiovascular risk and prognosis,and its clinical applications.Methods Data from the National Health and Nutrition Examination Survey(1999-2018)were analyzed.Cardiovascular risk factors were assessed,and the Framingham risk score(FRS)was calculated.Cox proportional hazards models were used with all-cause mortality and cardiovascular mortality as outcomes.Harrell's C-statistic was employed to evaluate the additional predictive value of ePWV.Results The association between ePWV and outcomes remained significant after adjusting for cardiovascular risk factors(HR=1.33,95％CI 1.21～1.50 for all-cause mortality,HR=1.51,95％CI 1.30～1.78 for cardiovascular mortality)and FRS(HR=1.22,95％CI 1.12～1.32 for all-cause mortality,HR=1.32,95％CI 1.10～1.59 for cardiovascular mortality).The model incorporating ePWV showed a higher Harrell's C-statistic compared to models with FRS or cardiovascular risk factors(P＜0.05).Conclusion ePWV could serve as a non-invasive,convenient and practical clinical parameter for assessing cardiovascular risk and prognosis.
关键词
估计的脉搏波传导速度/心血管危险因素/弗雷明汉风险评分/临床结局Key words
Estimated pulse wave velocity/Cardiovascular risk factor/Framingham risk score/Clinical outcome引用本文复制引用
出版年
2024
NETL
NSTL
万方数据