本文由小咖机器人翻译整理

期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02905-y

摘要内容如下：

QRISK算法使用来自数百万人的数据来帮助临床医生识别心血管疾病（CVD）高危人群。在这里，我们推导并外部验证了一种新的算法，我们将其命名为QR4，该算法结合了新的风险因素来分别评估男性和女性的10年心血管疾病风险。来自英国的998万和679万成年人的健康数据分别用于推导和验证该算法。使用病因特异性Cox模型来开发预测CVD风险的模型，并将QR4的性能与QRISK第3版、系统性冠状动脉风险评估2（SCORE2）和动脉粥样硬化性心血管疾病（ASCVD）风险评分进行比较。我们在男性和女性模型中均确定了7个新的风险因子（脑癌、肺癌、唐氏综合征、血癌、慢性阻塞性肺病、口腔癌和学习障碍），在女性模型中确定了另外2个新的风险因子（先兆子痫和产后抑郁症）。在外部验证中，QR4在女性（QR4和QRISK3分别为0.835（95%置信区间（CI），0.833-0.837）和0.831（95%CI，0.829-0.832））和男性（QR4和QRISK3分别为0.814（95%CI，0.812-0.816）和0.812（95%CI，0.810-0.814））中的C统计量均高于QRISK3。在男性和女性中，QR4也比ASCVD和SCORE2风险评分更准确。与其他国际心血管疾病风险评分系统相比，QR4风险评分可识别新的风险人群，并在英国提供更好的心血管疾病风险预测。

英文原文如下：

Abstracts

QRISK algorithms use data from millions of people to help clinicians identify individuals at high risk of cardiovascular disease (CVD). Here, we derive and externally validate a new algorithm, which we have named QR4, that incorporates novel risk factors to estimate 10-year CVD risk separately for men and women. Health data from 9.98 million and 6.79 million adults from the United Kingdom were used for derivation and validation of the algorithm, respectively. Cause-specific Cox models were used to develop models to predict CVD risk, and the performance of QR4 was compared with version 3 of QRISK, Systematic Coronary Risk Evaluation 2 (SCORE2) and atherosclerotic cardiovascular disease (ASCVD) risk scores. We identified seven novel risk factors in models for both men and women (brain cancer, lung cancer, Down syndrome, blood cancer, chronic obstructive pulmonary disease, oral cancer and learning disability) and two additional novel risk factors in women (pre-eclampsia and postnatal depression). On external validation, QR4 had a higher C statistic than QRISK3 in both women (0.835 (95% confidence interval (CI), 0.833-0.837) and 0.831 (95% CI, 0.829-0.832) for QR4 and QRISK3, respectively) and men (0.814 (95% CI, 0.812-0.816) and 0.812 (95% CI, 0.810-0.814) for QR4 and QRISK3, respectively). QR4 was also more accurate than the ASCVD and SCORE2 risk scores in both men and women. The QR4 risk score identifies new risk groups and provides superior CVD risk prediction in the United Kingdom compared with other international scoring systems for CVD risk.

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