<br>亚太地区心血管疾病风险预测：SCORE2 亚太模型。,European Heart Journal

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亚太地区心血管疾病风险预测：SCORE2 亚太模型。
European Heart Journal ( IF 37.6 ) Pub Date : 2025-02-21 , DOI: 10.1093/eurheartj/ehae609
, Steven H J Hageman ₁ , Zijuan Huang ₂ , Hokyou Lee _{3,

4} , Stephen Kaptoge ₅ , Jannick A N Dorresteijn ₁ , Lisa Pennells ₅ , Emanuele Di Angelantonio ₅ , Frank L J Visseren ₁ , Hyeon Chang Kim _{3,

4} , Sofian Johar ₆ , , ,

Affiliation

背景和目标通过系统重新校准 SCORE2 风险算法，改进亚太地区无 CVD 或糖尿病史例个体 10 年心血管疾病（CVD）事件风险的估计。方法系统地重新校准了性别特异性和竞争性风险调整后的 SCORE2 算法，以反映在四个亚太风险地区观察到的 CVD 发病率，这些地区根据国家级世界卫生组织年龄和性别标准化 CVD 死亡率定义。使用与原始 SCORE2 模型相同的方法，使用每个区域的预期 CVD 发生率和风险因素分布完成对每个风险区域的重新校准。结果使用 8 405 574 例（556 421 例 CVD 事件）的 CVD 死亡率和发病率数据估计风险区域特异性 CVD 发病率。为了进行外部验证，在来自 12 个国家的 13 项前瞻性研究中分析了 9 560 266 名既往无 CVD 或糖尿病患者的数据（350 550 例 CVD 事件）。外部验证数据集中 SCORE2 亚太算法的合并 C 指数为 .710 [95% 置信区间（CI） .677-.744]。队列特异性 C 指数范围为 .605 （95% CI .597-.613）至 .840 （95% CI .771-.909）。估计的 CVD 风险在亚太地区风险地区相差数倍。例如，收缩压为 140 mmHg、总胆固醇为 5.5 mmol/L 和高密度脂蛋白胆固醇为 1.3 mmol/L 的 50 岁非吸烟者的估计 10 年 CVD 风险范围为低风险国家男性的 7% 到极高风险国家男性的 14%，低风险国家的女性为 3% 到极高风险国家的女性为 13%。结论 SCORE2 亚太算法已经过校准，以估计亚洲和大洋洲明显健康人群的 10 年心血管疾病风险，从而加强对亚太地区心血管疾病风险较高的个体的识别。

"点击查看英文标题和摘要"

Risk prediction of cardiovascular disease in the Asia-Pacific region: the SCORE2 Asia-Pacific model.

BACKGROUND AND AIMS To improve upon the estimation of 10-year cardiovascular disease (CVD) event risk for individuals without prior CVD or diabetes mellitus in the Asia-Pacific region by systematic recalibration of the SCORE2 risk algorithm. METHODS The sex-specific and competing risk-adjusted SCORE2 algorithms were systematically recalibrated to reflect CVD incidence observed in four Asia-Pacific risk regions, defined according to country-level World Health Organization age- and sex-standardized CVD mortality rates. Using the same approach as applied for the original SCORE2 models, recalibration to each risk region was completed using expected CVD incidence and risk factor distributions from each region. RESULTS Risk region-specific CVD incidence was estimated using CVD mortality and incidence data on 8 405 574 individuals (556 421 CVD events). For external validation, data from 9 560 266 individuals without previous CVD or diabetes were analysed in 13 prospective studies from 12 countries (350 550 incident CVD events). The pooled C-index of the SCORE2 Asia-Pacific algorithms in the external validation datasets was .710 [95% confidence interval (CI) .677-.744]. Cohort-specific C-indices ranged from .605 (95% CI .597-.613) to .840 (95% CI .771-.909). Estimated CVD risk varied several-fold across Asia-Pacific risk regions. For example, the estimated 10-year CVD risk for a 50-year-old non-smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and high-density lipoprotein cholesterol of 1.3 mmol/L, ranged from 7% for men in low-risk countries to 14% for men in very-high-risk countries, and from 3% for women in low-risk countries to 13% for women in very-high-risk countries. CONCLUSIONS The SCORE2 Asia-Pacific algorithms have been calibrated to estimate 10-year risk of CVD for apparently healthy people in Asia and Oceania, thereby enhancing the identification of individuals at higher risk of developing CVD across the Asia-Pacific region.

更新日期：2024-09-01

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