| アブストラクト | Bicuspid aortic valve disease (BAV) is the most common congenital heart condition, and early detection can improve outcomes for patients. In this case-control study, patients with a diagnosis of BAV were identified from their electronic primary-care records in the UK's Clinical Practice Research Datalink (CPRD). Each case was propensity-score matched to up to five controls. The clinical features recorded before diagnosis were compared. The proposed clinical features shown to be associated with BAV (p < 0.05) were incorporated into a multivariable regression model. We identified 2898 cases. The prevalence of BAV in the CPRD was 1 in 5181, significantly lower than expected, suggesting that diagnosis and/or recording could be improved. The following biologically plausible clinical features were associated with a subsequent diagnosis of BAV: palpitations (OR: 2.86 (95% CI: 1.60, 3.16)), atrial fibrillation (AF) (OR: 2.25 (95% CI: 1.60, 3.16)) and hypertension (OR: 1.72 (1.48, 2.00)). The best model had an AUC of 0.669 (95% CI: 0.658 to 0.680), a positive predictive value (PPV) of 5.9% (95% CI: 4.0% to 8.7%) and a negative predictive value (NPV) of 99% (95% CI: 99% to 99%) at a population prevalence of 1%. This study indicates that palpitations, hypertension and AF should trigger a clinical suspicion of BAV and assessment via echocardiography. It also demonstrates the potential to develop a prediction model for BAV to stratify patients for echocardiography screening. |
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| ジャーナル名 | Journal of personalized medicine |
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| 投稿日 | 2022/8/27 |
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| 投稿者 | Evans, William; Akyea, Ralph Kwame; Weng, Stephen; Kai, Joe; Qureshi, Nadeem |
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| 組織名 | Primary Care Stratified Medicine (PRISM), Centre for Academic Primary Care,;School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK.;Statistical Decision Sciences, Cardiovascular and Metabolism, Janssen Research;and Development, High Wycombe HP12 4EG, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/36013239/ |
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