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| 1 | 一种房颤风险评分系统的建立(Framingham心脏研究):基于社区的队列研究显示文摘背景房颤导致了发病率和病死率的显著上升。本研究旨在建立一种预测个体罹患房颤绝对风险的风险评分系统,并提供研究人员评价新危险因素的流程。方法作者评估了Framingham心脏研究中于1968年6月至1987年9月间进行了8044次检测的4764例参与者(55%为女性,年龄45~95岁)。此后,参与者被随访至房颤首发,随访期最长达10年。多变量Coxi回归确认出1(1年内罹患房颤的临床危险因素。次级分析纳入了常规超声心动图检测指标(5152例4参与者,7156次检测)对房颤风险进行再分层评估,并评价超声检测指标能否提高风险预测能力。结果4764例参与者中的457例4(10%)罹患房颤。年龄、性别、体重指数、收缩压、降压治疗、PR间期、有临床意义的心脏杂音及心力衰竭与房颤相关,并被纳入了风险评分模型(除体重指数P=0.08外,其余均为P〈0.05),模型的C统计量为0.78(95%CI0.76~0.80)。10年房颤风险随年龄变化:年龄〈65岁的人群中53例(1%)风险高于15%,而〉65岁的人群中为783例(27%)。为提高预测能力而纳入超声检测指标仅使模型C统计量略微增高,由0.78(95%C10.75~0.80)增至0.79(95%CI0.77~0.82:P=0.005)。超声心动图检测指标并不能改善风险再分层评估(P=0.18)。结论基于社区医疗中易得的临床因素建立的风险评分系统,有助于确认社区个体罹患房颤的风险,评估技术或标志物能否改善风险预测,以及针对高危个体采取预防措施。 | Renate B Schnabel Lisa M Sullivan Daniel Levy Michael J Pencina Joseph M Massaro Ralph B D'Agostino Sr Christopher Newton-Cheh Jennifer F Yamamoto Jared W Magnani Thomas M Tadros William B Kannel Thomas J Wang Patrick T Ellinor Philip A Wolf Ramachanclran S Vasan Emelia J Benjamin 黄刚(译) | 2009 | 世界临床医学2009，，9： | 2 |
| 2 | Fibrinogen,cigarette smoking,and risk of cardiovascular disease:insights from the Framingham study显示文摘 | Kannel W B D'Agostino R B Belanger A J | 1987 | Am Heart J1987，113，4： | 1 |
| 3 | Prevalence, incidence,prognosis, and predisposing conditions for atrial fibrillation: population-based estimates显示文摘 | Kannel W B Wolf P A Benjamin E J | 1998 | Am J Cardiol1998，82，8： | 1 |
| 4 | Factors of risk in thedevelopment of coronary heart disease-six- year follow-up experience:the Framingham study显示文摘 | Kannel WB Dawber TR Kagan A | 1961 | Ann Intern Med1961，55，： | 1 |
| 5 | Prevalence,incidence prognosis,and predisposing conditions for atrial fibrillation:population based estimates显示文摘 | Kannel W B Wolf P A Benjamin E J | 1998 | Am J Cardiol1998，82，8： | 1 |
| 6 | Atrial fibrillation as an independent risk factor for stroke: the Framingham Study显示文摘 | Wolf P A Abbott R D Kannel W B | 1991 | Stroke1991，22，8： | 1 |
| 7 | Sudden death: lessons from subsets inpopulation studies显示文摘 | Kannel WB Schatzkin A | 1985 | J Am CoU Cardiol1985，5，6： | 1 |
| 8 | Atrial fibrillation as an independent risk factor for stroke: the Framingham Study显示文摘 | Wolf P A Abbott R D Kannel W B | 1991 | Stroke1991，22，8： | 1 |
| 9 | Atrial fibrillation as an independent risk factor for stroke: the Framingham Study显示文摘 | Wolf P A Abbott R D Kannel W B | 1991 | Stroke1991，22，8： | 1 |
| 10 | Atrial fibrillation as an independent risk factor for stroke: the Framingham Study 显示文摘 | Wolf P A Abbott R D Kannel W B | 1991 | Stroke1991，22，8： | 1 |
| 11 | Atrial fibrillation as an independent risk factor for stroke : the Framingham Study 显示文摘 | Wolf P A Abbott R D Kannel W B | 1991 | Stroke1991，22，： | 1 |
| 12 | Atrial fibrillation as an independent risk factor for stroke: The Framingham study显示文摘 | Wolf P A Abbott R D Kannel W B | 1991 | Stroke1991，22，2： | 1 |
| 13 | Estimate of surface temperature during rolling contac显示文摘 | Kannel J W Barber S A | | 0，，03： | 1 |
| 14 | Unrecognized myocardial infarction and hypertention: The Framinghan study 显示文摘 | William B Kannel WB Dannenberg A | 1985 | Am Heart J1985，109，： | 1 |
| 15 | influence of heart tate on mortality among persons with hypertension:The framingham study显示文摘 | Gillman MW Kannel WB Belanger A | 1993 | Am Heart J1993，125，： | 1 |
| 16 | Influence of heart rate on morality among persons with hypertension: the framingham study 显示文摘 | Kannel WB Belanger A | 1993 | Am Heart J1993，125，： | 1 |
| 17 | Psychological predictors of hypertension in the Fyamingham study显示文摘 | Markovitz J H Matthews K A Kannel W B | 1993 | JAMA1993，270，20： | 1 |
| 18 | Influence of heart rate on mortality among persons with hypertension: the Framingham Study显示文摘 | Gillman MW Kannel WB Belanger A | 1993 | Am Heart J1993，125，4： | 1 |
| 19 | Atrial fibrillation as an independent risk factor for stroke: the framingham study 显示文摘 | Wolf P A Abbott R D Kannel W B | 1991 | Stroke1991，22，6： | 1 |
| 20 | Influence of heart rate on mortality among persons with hypertension: the Framingham Study 显示文摘 | GILLMAN MW KANNEL WB BELANGER A | 1993 | Am Heart J1993，125，4： | 1 |
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