孟加拉人动脉粥样硬化性心血管疾病风险评分系统的比较。

Mymensingh medical journal : MMJ Pub Date : 2024-10-01
M Ullah, M M Billah, S K Saha, G K Paul, M A K Akanda, A A S Majumder
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引用次数: 0

摘要

风险分层是动脉粥样硬化性心血管疾病一级预防的重要第一步。为此,全世界有许多评分系统。我们试图评估两种最新的评分系统。评估哪种系统更适合居住在孟加拉国的孟加拉人。这项横断面研究于 2019 年 1 月至 2019 年 6 月在孟加拉国的一家二级医院和一家三级医院进行。研究共纳入 274 名患者。他们使用 ASCVD 评分系统和 QRISK3 评分系统对未来 10 年发生动脉粥样硬化性心血管事件(心肌梗死和/或中风)的风险进行了评估。患者的平均年龄为(57.1±12.8)岁,其中男性 192 人,女性 92 人。一半(50.4%)的患者吸烟,一半(51.1%)的患者患有高血压,45.6%的患者患有糖尿病,29.6%的患者有过早发生动脉粥样硬化性心血管疾病的家族史,27.0%的患者超重或肥胖。根据 ASCVD 评分法,36.5% 的患者属于高风险,32.5% 属于中度风险,16.4% 属于未来 10 年发生心血管事件的低风险,14.6% 的患者无法进行风险评估。根据 QRISK3 评分方法,55.5% 的患者有高风险,20.8% 的患者有中度风险,16.0% 的患者有低风险,7.7% 的患者无法进行风险评估。QRISK3 评分系统的预测价值较高,能发现更多在未来 10 年内发生动脉粥样硬化性心血管事件的高风险患者。QRISK3 还能对年龄较小的患者进行评估。目前,QRISK3 是评估孟加拉国人群心血管风险的较好系统。我们需要进一步研究,以评估其在临床疗效和成本效益方面的作用。
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Comparison of Atherosclerotic Cardiovascular Disease Risk Scoring Systems in Bangladeshi Population.

Risk stratification is an important initial step for primary prevention of atherosclerotic cardiovascular diseases. There are a number of scoring systems for this purpose worldwide. We tried to evaluate two most updated scoring systems. To assess which one is the better for Bangladeshi population residing in Bangladesh. This cross-sectional study was conducted in a secondary and a tertiary care hospital in Bangladesh from January 2019 to June 2019. Total 274 patients were included in the study. They were evaluated using ASCVD scoring system and QRISK3 scoring system for the risk of atherosclerotic cardiovascular event (myocardial infarction and/or stroke) in next 10 years. Average age of the patients was 57.1±12.8 years and 192 of them were male and 92 of them were female. Half (50.4%) of the patients were smoker, half (51.1%) of them were hypertensive, 45.6% of them were diabetic, 29.6% of them had family history of premature atherosclerotic cardiovascular diseases and 27.0% of them were overweight or obese. According to ASCVD scoring 36.5% patients were at high risk, 32.5% at intermediate risk, 16.4% at low risk of cardiovascular events in next 10 years and risk evaluation was not possible in 14.6% patients. According to QRISK3 scoring method 55.5% are at high risk, 20.8% at intermediate risk, 16.0% at low risk of cardiovascular events and evaluation was not possible in 7.7% patients. Predictive value of QRISK3 scoring system is better to detect more patients who are at high risk for atherosclerotic cardiovascular events in next 10 years. QRISK3 can also evaluate the patients at a younger age. At present QRISK3 is better system to evaluate cardiovascular risk in Bangladeshi population. We need further study to evaluate its role in the form of clinical efficacy and cost effectiveness.

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