本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-1898

摘要内容如下：

背景

动脉粥样硬化性心血管疾病（ASCVD）的一级预防指南建议使用风险计算器（ASCVD风险评分）来评估10年内主要不良心血管事件（MACE）的风险。由于经常缺少必要的投入，因此最好采用机会主义风险评估的补充方法。

客观

开发并测试深度学习模型（CXR CVD-RISK），该模型通过常规胸片（CXR）评估10年MACE风险，并将其性能与传统ASCVD风险评分进行比较，以确定他汀类药物的资格。

设计

风险预测研究。

设置

门诊患者可能符合一级心血管预防的条件。

参与者

CXR心血管疾病风险模型是利用一项癌症筛查试验的数据开发的。由于计算ASCVD风险评分的输入缺失，8869名未知ASCVD风险的门诊患者和2132名可计算ASCVD风险评分的已知风险的门诊患者进行了外部验证。

测量

CXR CVD风险与ASCVD风险评分预测的10年MACE

结果

在8869例具有未知ASCVD风险的门诊患者中，CXR CVD-RISK预测的风险为7.5%或更高的患者，在校正危险因素后，10年内发生MACE的风险更高（校正风险比[HR]，1.73[95%CI，1.47-2.03]）。在另外2132例已知有ASCVD风险的门诊患者中，CXR CVD风险预测的MACE超过了传统的ASCVD风险评分（校正HR，1.88[CI，1.24至2.85]）。

局限性

使用电子病历的回顾性研究设计。

结论

在单一CXR的基础上，CXR CVD-RISK可预测超过临床标准的10年MACE，并可能有助于识别因数据缺失而无法计算ASCVD风险评分的高危个体。

主要资金来源

没有。

英文原文如下：

Abstracts

BACKGROUND  Guidelines for primary prevention of atherosclerotic cardiovascular disease (ASCVD) recommend a risk calculator (ASCVD risk score) to estimate 10-year risk for major adverse cardiovascular events (MACE). Because the necessary inputs are often missing, complementary approaches for opportunistic risk assessment are desirable.

OBJECTIVE  To develop and test a deep-learning model (CXR CVD-Risk) that estimates 10-year risk for MACE from a routine chest radiograph (CXR) and compare its performance with that of the traditional ASCVD risk score for implications for statin eligibility.

DESIGN  Risk prediction study.

SETTING  Outpatients potentially eligible for primary cardiovascular prevention.

PARTICIPANTS  The CXR CVD-Risk model was developed using data from a cancer screening trial. It was externally validated in 8869 outpatients with unknown ASCVD risk because of missing inputs to calculate the ASCVD risk score and in 2132 outpatients with known risk whose ASCVD risk score could be calculated.

MEASUREMENTS  10-year MACE predicted by CXR CVD-Risk versus the ASCVD risk score.

RESULTS  Among 8869 outpatients with unknown ASCVD risk, those with a risk of 7.5% or higher as predicted by CXR CVD-Risk had higher 10-year risk for MACE after adjustment for risk factors (adjusted hazard ratio [HR], 1.73 [95% CI, 1.47 to 2.03]). In the additional 2132 outpatients with known ASCVD risk, CXR CVD-Risk predicted MACE beyond the traditional ASCVD risk score (adjusted HR, 1.88 [CI, 1.24 to 2.85]).

LIMITATION  Retrospective study design using electronic medical records.

CONCLUSION  On the basis of a single CXR, CXR CVD-Risk predicts 10-year MACE beyond the clinical standard and may help identify individuals at high risk whose ASCVD risk score cannot be calculated because of missing data.

PRIMARY FUNDING SOURCE  None.

-----------分割线---------

点击链接：https://www.mediecogroup.com/community/user/vip/categories/ ，成为医咖会员，获取12项专属权益。