QRISK3 underestimates the risk of cardiovascular events in patients with COPD.
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アブストラクト BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease (CVD). The extent to which the excess CVD risk is captured by risk factors in QRISK, a widely used CVD risk scoring tool, is not well studied.METHODS:We created an incidence cohort of diagnosed COPD patients from the United Kingdom (UK) Clinical Practice Research Datalink GOLD database (January 1998-July 2018). The outcome was a composite of fatal or non-fatal CVD events. Sex-specific age-standardised incidence ratios (SIR) were compared with values for the UK primary-care population. The observed 10-year CVD risk was derived using the Kaplan-Meier estimator and was compared with predicted 10-year risk from the QRISK3 tool.RESULTS:13 208 patients (mean age 64.9 years, 45% women) were included. CVD incidence was 3.53 events per 100 person-years. The SIR of CVD was 1.71 (95% CI 1.61 to 1.75) in women and 1.62 (95%CI 1.54-1.64) in men. SIR was particularly high among patients younger than 65 years (women=2.13 (95% CI 1.94 to 2.19); men=1.86 (95% CI 1.74 to 1.90)). On average, the observed 10-year risk was 52% higher than QRISK predicted score (33.5% vs 22.1%). The difference was higher in patients younger than 65 years (observed risk 82% higher than predicted).CONCLUSION:People living with COPD are at a significantly heightened risk of CVD over and beyond their predicted risk. This is particularly the case for younger people whose 10-year CVD risk can be >80% higher than predicted. Risk scoring tools must be validated and revised to provide accurate CVD predictions in patients with COPD.ジャーナル名 Thorax 投稿日 2023/12/5 投稿者 Amegadzie, Joseph Emil; Gao, Zhiwei; Quint, Jennifer K; Russell, Richard; Hurst, John R; Lee, Tae Yoon; Sin, Don D; Chen, Wenjia; Bafadhel, Mona; Sadatsafavi, Mohsen 組織名 Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, The;University of British Columbia, Vancouver, British Columbia, Canada.;Division of Community Health and Humanities, Faculty of Medicine, Memorial;University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.;School of Public Health, National Heart and Lung Institute, Imperial College;London, London, UK.;Respiratory Medicine Unit, Nuffield Department of Clinical Medicine, University;of Oxford, Oxford, UK.;King's Centre of Lung Health, Peter Gorer Dept of Immunobiology, Faculty of Life;Sciences and Medicine, King's College London, London, UK.;Academic Unit of Respiratory Medicine, University College London Medical School,;London, UK.;Centre for Heart Lung Innovation, Faculty of Medicine, The University of British;Columbia, Vancouver, British Columbia, Canada.;Saw Swee Hock School of Public Health, National University of Singapore,;Singapore.;University of British Columbia, Vancouver, British Columbia, Canada;msafavi@mail.ubc.ca. Pubmed リンク https://www.ncbi.nlm.nih.gov/pubmed/38050168/ -
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