<br>使用传统危险因素和冠状动脉钙推导冠状动脉年龄计算器：动脉粥样硬化的多种族研究,Journal of the American Heart Association

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使用传统危险因素和冠状动脉钙推导冠状动脉年龄计算器：动脉粥样硬化的多种族研究
Journal of the American Heart Association ( IF 5.0 ) Pub Date : 2021-03-05 , DOI: 10.1161/jaha.120.019351
Michael J Blaha ₁ , Isaac N Naazie ₁ , Miguel Cainzos-Achirica ₁ , Zeina A Dardari ₁ , Andrew P DeFilippis ₂ , Robyn L McClelland ₃ , Mohammadhassan Mirbolouk ₄ , Olusola A Orimoloye ₅ , Omar Dzaye ₁ , Khurram Nasir _{4,

6} , John H Page ₇

Affiliation

背景向个体患者传达冠心病 (CHD) 风险的最佳方法尚不清楚。最近的研究支持“冠心病年龄”的概念，以实现更有效的风险沟通。基于我们之前验证的 MESA（动脉粥样硬化多种族研究）10 年 CHD 风险评分，我们将个体的冠状动脉年龄定义为平均健康个体的估计 CHD 风险与指数个体计算得出的风险相当的年龄。方法和结果我们通过以下方式得出冠状动脉年龄：（1）计算 MESA 10 年 CHD 风险； (2) 在数学上将其设置为一个方程，该方程描述了平均健康 MESA 参与者的风险，作为年龄的函数； (3) 求解年龄。将所得冠脉年龄的风险辨别与实际年龄、MESA CHD 风险评分和单独的 CAC 进行比较。大约 95% 的冠状动脉年龄值比实际年龄小 30 岁到高 30 岁。尽管发生CHD事件的个体与未发生CHD事件的个体的平均实际年龄分别为67.4岁和61.8岁，但包括CAC在内的冠脉年龄差异更大（80.6岁和62.8岁）。 CAC冠状动脉年龄与MESA CHD风险评分具有相同的预测能力，并且优于实际年龄和单独CAC。结论新推导的冠状动脉年龄是MESA CHD风险的便捷转换，保留了很好的风险辨别力。这种易于沟通的工具可供患者和临床医生使用，有可能促进日常护理中的风险沟通。

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Derivation of a Coronary Age Calculator Using Traditional Risk Factors and Coronary Artery Calcium: The Multi‐Ethnic Study of Atherosclerosis

BackgroundThe optimal method for communicating coronary heart disease (CHD) risk to individual patients is not yet clear. Recent research supports the concept of "coronary age" for more effective risk communication. We defined an individual's coronary age as the age at which an average healthy individual would have an equivalent estimated CHD risk as that calculated for the index individual, building on our previously validated MESA (Multi‐Ethnic Study of Atherosclerosis) 10‐year CHD Risk Score equations with and without coronary artery calcium (CAC).Methods and ResultsWe derived a coronary age by (1) calculating the MESA 10‐year CHD risk; (2) mathematically setting this equal to an equation describing risk of an average healthy MESA participant, as a function of age; and (3) solving for age. The risk discrimination of the resultant coronary age was compared with that of chronological age, the MESA CHD Risk Score, and CAC alone. Approximately 95% of coronary age values ranged from 30 years less to 30 years higher than chronological age. Although the mean chronological age of individuals experiencing CHD events compared with those free of events was 67.4 versus 61.8 years, the difference in coronary age including CAC was larger (80.6 versus 62.8 years). Coronary age with CAC had identical predictive ability to that of MESA CHD Risk Score and outperformed chronological age and CAC alone.ConclusionsThe newly derived coronary age is a convenient transformation of MESA CHD Risk, retaining very good risk discrimination. This easy‐to‐communicate tool will be available for patients and clinicians, potentially facilitating risk communication in routine care.

更新日期：2021-03-16

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