用SCORE2 (OP)和Framingham风险评估结合生物衰老指标预测心血管发病率和死亡率

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Anna Tirkkonen, Jonathan K L Mak, Johan G Eriksson, Pauliina Halonen, Juulia Jylhävä, Sara Hägg, Linda Enroth, Jani Raitanen, Iiris Hovatta, Tuija Jääskeläinen, Seppo Koskinen, Markus J Haapanen, Mikaela B von Bonsdorff, Laura Kananen
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引用次数: 0

摘要

背景与目的:除了现有的心血管疾病风险指标,如Framingham风险评分(FRS)和系统性冠状动脉风险评估(SCORE2)/SCORE2- older Persons (OP)外,关于生物老化(BA)指标是否能增强心血管疾病(CVD)结局的风险评估的研究很少。我们探讨了BA指标,即Rockwood脆弱指数(FI)和白细胞端粒长度(TL)是否比传统的CVD风险指标更能提高中老年无CVD人群CVD结局的预测准确性。方法:数据包括来自三个基于人群的队列:TwinGene、Health 2000 (H2000)和赫尔辛基出生队列研究的14118名个体,按基线年龄分组(结果:在三个研究队列和年龄组中:(i)较高的FI(而不是TL)与较高的CVD发生率相关(P结论:我们提供了强有力的证据,表明基线时较高的FI值与中老年无CVD个体发生CVD的风险增加有关,同时根据FRS或SCORE2/SCORE2- op考虑风险时也是如此。FI比传统的CVD风险指标提高了CVD预后的预测准确性,即使在单独使用时也显示出令人满意的预测准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicting cardiovascular morbidity and mortality with SCORE2 (OP) and Framingham risk estimates in combination with indicators of biological ageing.

Background and objective: Previous research assessing whether biological ageing (BA) indicators can enhance the risk assessment of cardiovascular disease (CVD) outcomes beyond established CVD risk indicators, such as Framingham Risk Score (FRS) and Systematic Coronary Risk Evaluation (SCORE2)/SCORE2-Older Persons (OP), is scarce. We explored whether BA indicators, namely the Rockwood Frailty Index (FI) and leukocyte telomere length (TL), improve predictive accuracy of CVD outcomes beyond the traditional CVD risk indicators in general population of middle-aged and older CVD-free individuals.

Methods: Data included 14 118 individuals from three population-based cohorts: TwinGene, Health 2000 (H2000), and the Helsinki Birth Cohort Study, grouped by baseline age (<70, 70+). The outcomes were incident CVD and CVD mortality with 10-year follow-up. Risk estimations were assessed using Cox regression and predictive accuracies with Harrell's C-index.

Results: Across the three study cohorts and age groups: (i) a higher FI, but not TL, was associated with a higher occurrence of incident CVD (P < .05), (ii) also when considering simultaneously the baseline CVD risk according to FRS or SCORE2/SCORE2-OP (P < .05) (iii) adding FI to the FRS or SCORE2/SCORE2-OP model improved the predictive accuracy of incident CVD. Similar findings were seen for CVD mortality, but less consistently across the cohorts.

Conclusions: We show robust evidence that a higher FI value at baseline is associated with an increased risk of incident CVD in middle-aged and older CVD-free individuals, also when simultaneously considering the risk according to the FRS or SCORE2/SCORE2-OP. The FI improved the predictive accuracy of CVD outcomes beyond the traditional CVD risk indicators and demonstrated satisfactory predictive accuracy even when used independently.

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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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