西班牙终身心血管风险的更新和验证:IberLifeRisk2

IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Clinica e Investigacion en Arteriosclerosis Pub Date : 2023-05-01 DOI:10.1016/j.arteri.2022.09.003
Carlos Brotons , Irene Moral-Peláez , Johanna Vicuña , Cristina Ameixeiras , Carlos Fernández-Lavandera , Miguel Ángel Sánchez-Chaparro
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引用次数: 2

摘要

引言在西班牙工作人群中估计终身心血管风险的功能IBERLIFERISK获得了令人满意的判别;然而,男性的风险略有高估,女性的风险则有所低估。目的在延长随访3年后,重新校准当前的终生风险方程。方法回顾性队列研究。762.058名在2004年至2007年期间接受职业健康检查的工人也包括在内。对截至2017年12月的所有暂时性疾病发作和心血管死亡率进行了评估。将回归模型结合起来,以考虑衍生队列中估计心血管风险时存在的竞争风险。通过图形化表示验证队列中10年随访时预期和观察到的事件的比例,按风险十分位数进行分层,并计算Spiegelholter Z统计量来进行校准。使用受试者工作曲线(ROC)并计算Harrell的C指数以图形方式评估辨别度。结果平均年龄35.48岁(标准差10.56),男性71.14%。男性的Harrell C指数为0.78(95%CI 0.76-0.79),女性为0.73(95%CI 0.69-0.77)。总的来说,尽管Spiegelholter Z统计数据在两性中都没有统计学意义(p>0.05),但在最后十分之一的风险中,女性和男性都有轻微的低估和高估。
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Actualización y validación del riesgo cardiovascular de por vida en España: IBERLIFERISK2

Introduction

The function to estimate lifetime cardiovascular risk –IBERLIFERISK– in Spanish working population, obtained a satisfactory discrimination; however, there was a slight overestimation of the risk in men and an underestimation of the risk in women.

Objective

To recalibrate the current lifetime risk equation after extending the follow-up by 3 years.

Methods

Retrospective cohort study. 762.058 workers who underwent an occupational health examination between 2004 and 2007 were included. All episodes of temporary sickness and cardiovascular mortality up to December 2017 were evaluated. Regression models were combined to take into account the presence of competing risks in estimating cardiovascular risk in the derivation cohort. Calibration was performed by graphically representing the proportion of expected and observed events at 10 years of follow-up in the validation cohort, stratifying by risk deciles and calculating the Spiegelhalter Z statistic. Discrimination was evaluated graphically using the Receiver Operating Curve (ROC) and calculating Harrell's C index.

Results

The mean age was 35.48 years (SD 10.56). 71.14% were men. Harrell's C index was 0.78 (95% CI 0.76-0.79) in men and 0.73 (95% CI 0.69-0.77) in women. In general, there was a slight degree of underestimation in women and overestimation in men in the last decile of risk, although the Spiegelhalter Z statistic was not statistically significant in both sexes (p>0.05).

Conclusions

The updated model continues to discriminate satisfactorily, although the model's calibration has not substantially improved with the new update.

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来源期刊
Clinica e Investigacion en Arteriosclerosis
Clinica e Investigacion en Arteriosclerosis PERIPHERAL VASCULAR DISEASE-
CiteScore
3.20
自引率
6.20%
发文量
44
审稿时长
40 days
期刊介绍: La publicación idónea para acceder tanto a los últimos originales de investigación como a formación médica continuada sobre la arteriosclerosis y su etiología, epidemiología, fisiopatología, diagnóstico y tratamiento. Además, es la publicación oficial de la Sociedad Española de Arteriosclerosis.
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