Simultaneous derivation, validation, and comparison of predictor hazard ratios for cardiovascular risk prediction equations in patients with diabetes from high versus non-high income countries: cohort study.
Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Department of Chronic Diseases and Health Promotion, Yinzhou District Centre for Disease Control and Prevention, Ningbo, China.
Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand.
Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China peigao@bjmu.edu.cn.
Peking University Clinical Research Institute, Peking University, Beijing, China.
利用深度学习从英国生物银行42059名及Mass General Brigham生物银行2745名参与者的腹部MRI中提取107个脾脏影像组学特征,其中10个特征与冠状动脉疾病相关。对这些特征的基因组关联分析识别出219个位点,包括9p21;该位点变异与脾脏连续纹理区域异质性等特征相关。研究MRI结果内部一致,但外部临床验证因成像方案差异和患者临床异质性面临转化挑战。研究结合深度学习与基因组学,揭示脾脏可能参与冠状动脉疾病,并强调研究与临床影像组学间的转化差距。
2026年美国心脏协会/美国心脏病学会/多学会血脂异常管理指南就动脉粥样硬化性心血管疾病(ASCVD)风险评估及他汀一级预防适用人群提出新推荐。本研究旨在评估该指南对他汀一级预防的人群健康影响,采用2017至2023年美国国家健康与营养调查中30至79岁、无已知ASCVD的非妊娠成人全国代表性横断面样本,比较2026年与2018年血脂指南下他汀一级预防资格的变化。加权样本包括4366名参与者,代表1.545亿美国成人。结果显示,依据2026年指南,约8750万(56.6%)成人符合他汀一级预防条件,其中2150万(13.9%)为新符合条件者;70至79岁成人中超过93%、60至69岁中85%符合条件,而30至39岁仅11%。新符合条件人群较既往推荐人群更年轻、风险更低(平均10年ASCVD估计风险3.1% vs 6.1%)。结论认为,2026年血脂指南大幅扩大了美国他汀一级预防推荐人群,且主要为较低风险个体。
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