Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/25704 |
Resumo: | Background: This study aimed to identify the ideal cutoff point of the SAGE score, which indicates a high risk of pulse wave velocity (PWV) ≥10 m/s, in a sample of outpatients with and without systemic arterial hypertension (SAH), in the city of Santa Maria, RS. Because the SAGE score has not been validated so far in populations without the diagnosis of SAH, the applicability of sage in the sample of non-hypertensive individuals involved a hypothesis analysis. Materials and Methods: An analysis was performed in individuals with and without diagnosis of SAH, who underwent follow-up in a private cardiology service. The PWV was measured by oscillometric device (Dyna-MAPA-AOP®, Cardios, São Paulo, Brazil). A total of 307 individuals were included, who had data collected from medical records. After applying the SAGE score, the results were compared with the PWV. The ROC curve was elaborated using the Youden index in order to establish the best score that identifies patients at high risk of high PWV. Results: Age ranged from 30 to 92 years. PWV ≥ 10 m/s occurred only in patients aged ≥ 66 years. The ideal cutoff point in the SAGE score, according to the Youden Index, was identified in 6. In individuals with SAH (n=212), the ROC curve presented an area under the curve (AUC) with accuracy of 93.8% (95% CI from 90.8% to 96.8%, p ≤0.001). Of the 95 non-hypertensives, the cutoff point ≥ 6 was found to be the most accurate. The AUC determined the accuracy of the SAGE score of 96.9% (95% CI from 94.0% to 99.8%, p≤0.001). Analyzing the total population (with and without SAH, n=307), it was observed the accuracy of the SAGE score in predicting VOP ≥ 10 m/s of 94.8% (95% CI from 92.9% to 97.0%, p≤0.001). A qualitative analysis was performed, also seeking the best specificity of the method. A cutoff point 7 in the group with SAH (n=212) decreased sensitivity to 68%, but increased specificity to 92%, with a negative likelihood ratio (LR-) of 0.3467. This ensured that those with SAGE score <7 likely would not have high PWV. In the non-hypertensive group (n=95), the cutoff point adjustment to 7 decreased the sensitivity to 70% and increased the specificity to 95%, with an LR- of 0.3169. Conclusion: In a cross-sectional analysis of patients with and without SAH, a cutoff point ≥ 6 by Youden´s statistics was predictive of those individuals with PWV ≥ 10m/s. The qualitative analysis determined the best cutoff point as ≥ 7 to predict PWV ≥ 10m/s. |
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Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriaisRigidez vascularHipertensãoFatores de risco para doenças cardíacasVascular stiffnessHypertensionHeart disease risk factorsCNPQ::CIENCIAS DA SAUDEBackground: This study aimed to identify the ideal cutoff point of the SAGE score, which indicates a high risk of pulse wave velocity (PWV) ≥10 m/s, in a sample of outpatients with and without systemic arterial hypertension (SAH), in the city of Santa Maria, RS. Because the SAGE score has not been validated so far in populations without the diagnosis of SAH, the applicability of sage in the sample of non-hypertensive individuals involved a hypothesis analysis. Materials and Methods: An analysis was performed in individuals with and without diagnosis of SAH, who underwent follow-up in a private cardiology service. The PWV was measured by oscillometric device (Dyna-MAPA-AOP®, Cardios, São Paulo, Brazil). A total of 307 individuals were included, who had data collected from medical records. After applying the SAGE score, the results were compared with the PWV. The ROC curve was elaborated using the Youden index in order to establish the best score that identifies patients at high risk of high PWV. Results: Age ranged from 30 to 92 years. PWV ≥ 10 m/s occurred only in patients aged ≥ 66 years. The ideal cutoff point in the SAGE score, according to the Youden Index, was identified in 6. In individuals with SAH (n=212), the ROC curve presented an area under the curve (AUC) with accuracy of 93.8% (95% CI from 90.8% to 96.8%, p ≤0.001). Of the 95 non-hypertensives, the cutoff point ≥ 6 was found to be the most accurate. The AUC determined the accuracy of the SAGE score of 96.9% (95% CI from 94.0% to 99.8%, p≤0.001). Analyzing the total population (with and without SAH, n=307), it was observed the accuracy of the SAGE score in predicting VOP ≥ 10 m/s of 94.8% (95% CI from 92.9% to 97.0%, p≤0.001). A qualitative analysis was performed, also seeking the best specificity of the method. A cutoff point 7 in the group with SAH (n=212) decreased sensitivity to 68%, but increased specificity to 92%, with a negative likelihood ratio (LR-) of 0.3467. This ensured that those with SAGE score <7 likely would not have high PWV. In the non-hypertensive group (n=95), the cutoff point adjustment to 7 decreased the sensitivity to 70% and increased the specificity to 95%, with an LR- of 0.3169. Conclusion: In a cross-sectional analysis of patients with and without SAH, a cutoff point ≥ 6 by Youden´s statistics was predictive of those individuals with PWV ≥ 10m/s. The qualitative analysis determined the best cutoff point as ≥ 7 to predict PWV ≥ 10m/s.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESFundamentação Teórica: Este estudo teve como objetivo identificar o ponto de corte ideal do escore SAGE, o qual indica alto risco de velocidade da onda de pulso (VOP) ≥10 m/s, em uma amostra de pacientes ambulatoriais com e sem hipertensão arterial sistêmica (HAS), no município de Santa Maria, RS. Em vista do escore SAGE não ter sido validado até o presente momento em populações sem o diagnóstico de HAS, a aplicabilidade desse na amostra de indivíduos não hipertensos envolveu uma análise de hipótese. Materiais e Métodos: Foi realizado uma análise em indivíduos com e sem diagnóstico de HAS, que realizavam acompanhamento em serviço de cardiologia privado e tiveram a VOP medida por método oscilométrico validado (Dyna-MAPA-AOP®, Cardios, São Paulo, Brasil). Foram incluídos 307 indivíduos, que tiveram dados coletados em prontuário. Após ser aplicado o escore SAGE, comparou-se os resultados com a VOP. A curva ROC foi elaborada utilizando o índice de Youden, a fim de estabelecer a melhor pontuação que identificasse pacientes com alto risco de VOP elevada. Resultados: A idade variou dos 30 aos 92 anos. VOP ≥ 10 m/s ocorreu somente em pacientes com idade ≥ 66 anos. O ponto de corte ideal no escore SAGE, conforme o Índice de Youden, foi identificado em 6. Em indivíduos como HAS (n=212), a curva ROC apresentou área sob a curva com acurácia de 93,8% (IC95% de 90,8% a 96,8%, p ≤0,001). Dos 95 pacientes não hipertensos, o ponto de corte ≥ 6 foi encontrado como o de maior acurácia. A área sob a curva ROC determinou a acurácia do escore SAGE de 96,9% (IC95% de 94,0% a 99,8%, p≤0,001). Analisando-se a população total (com e sem HAS, n=307), observou-se a acurácia do escore SAGE em predizer VOP ≥ 10 m/s de 94,8% (IC95% de 92,9% a 97,0%, p≤0,001). Realizou-se uma análise qualitativa, buscando ainda a melhor especificidade do método. Um ponto de corte 7 no grupo com HAS (n=212) diminuiu a sensibilidade para 68%, mas aumentou a especificidade para 92%, com uma razão de verossimilhança negativa (RV-) de 0,3467; garantindo com precisão que aqueles com pontuações < 7 não teriam rigidez arterial elevada. No grupo de não hipertensos (n=95), o ajuste no ponto de corte para 7 diminuiu a sensibilidade para 70% e aumentou a especificidade para 95%, com uma RV- de 0,3169. Conclusão: Em uma análise transversal de pacientes com e sem HAS, observou-se um ponto de corte ≥ 6 pelo Índice de Youden, para predizer aqueles indivíduos com VOP ≥ 10m/s. A análise qualitativa determinou o melhor ponto de corte como ≥ 7 para predizer VOP ≥ 10m/s.Universidade Federal de Santa MariaBrasilCiências da SaúdeUFSMPrograma de Pós-Graduação em GerontologiaCentro de Educação Física e DesportosChemello, Diegohttp://lattes.cnpq.br/1908077314129147Chagas, PatríciaSaffi, Marco Aurélio LumertzWiehe, MarioPereira, Luiz Carlos Carneiro2022-08-01T17:29:45Z2022-08-01T17:29:45Z2022-07-19info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://repositorio.ufsm.br/handle/1/25704porAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSM2022-08-01T17:29:45Zoai:repositorio.ufsm.br:1/25704Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2022-08-01T17:29:45Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.none.fl_str_mv |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais |
title |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais |
spellingShingle |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais Pereira, Luiz Carlos Carneiro Rigidez vascular Hipertensão Fatores de risco para doenças cardíacas Vascular stiffness Hypertension Heart disease risk factors CNPQ::CIENCIAS DA SAUDE |
title_short |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais |
title_full |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais |
title_fullStr |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais |
title_full_unstemmed |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais |
title_sort |
Predição de rigidez aórtica elevada através do escore sage em uma amostra de pacientes ambulatoriais |
author |
Pereira, Luiz Carlos Carneiro |
author_facet |
Pereira, Luiz Carlos Carneiro |
author_role |
author |
dc.contributor.none.fl_str_mv |
Chemello, Diego http://lattes.cnpq.br/1908077314129147 Chagas, Patrícia Saffi, Marco Aurélio Lumertz Wiehe, Mario |
dc.contributor.author.fl_str_mv |
Pereira, Luiz Carlos Carneiro |
dc.subject.por.fl_str_mv |
Rigidez vascular Hipertensão Fatores de risco para doenças cardíacas Vascular stiffness Hypertension Heart disease risk factors CNPQ::CIENCIAS DA SAUDE |
topic |
Rigidez vascular Hipertensão Fatores de risco para doenças cardíacas Vascular stiffness Hypertension Heart disease risk factors CNPQ::CIENCIAS DA SAUDE |
description |
Background: This study aimed to identify the ideal cutoff point of the SAGE score, which indicates a high risk of pulse wave velocity (PWV) ≥10 m/s, in a sample of outpatients with and without systemic arterial hypertension (SAH), in the city of Santa Maria, RS. Because the SAGE score has not been validated so far in populations without the diagnosis of SAH, the applicability of sage in the sample of non-hypertensive individuals involved a hypothesis analysis. Materials and Methods: An analysis was performed in individuals with and without diagnosis of SAH, who underwent follow-up in a private cardiology service. The PWV was measured by oscillometric device (Dyna-MAPA-AOP®, Cardios, São Paulo, Brazil). A total of 307 individuals were included, who had data collected from medical records. After applying the SAGE score, the results were compared with the PWV. The ROC curve was elaborated using the Youden index in order to establish the best score that identifies patients at high risk of high PWV. Results: Age ranged from 30 to 92 years. PWV ≥ 10 m/s occurred only in patients aged ≥ 66 years. The ideal cutoff point in the SAGE score, according to the Youden Index, was identified in 6. In individuals with SAH (n=212), the ROC curve presented an area under the curve (AUC) with accuracy of 93.8% (95% CI from 90.8% to 96.8%, p ≤0.001). Of the 95 non-hypertensives, the cutoff point ≥ 6 was found to be the most accurate. The AUC determined the accuracy of the SAGE score of 96.9% (95% CI from 94.0% to 99.8%, p≤0.001). Analyzing the total population (with and without SAH, n=307), it was observed the accuracy of the SAGE score in predicting VOP ≥ 10 m/s of 94.8% (95% CI from 92.9% to 97.0%, p≤0.001). A qualitative analysis was performed, also seeking the best specificity of the method. A cutoff point 7 in the group with SAH (n=212) decreased sensitivity to 68%, but increased specificity to 92%, with a negative likelihood ratio (LR-) of 0.3467. This ensured that those with SAGE score <7 likely would not have high PWV. In the non-hypertensive group (n=95), the cutoff point adjustment to 7 decreased the sensitivity to 70% and increased the specificity to 95%, with an LR- of 0.3169. Conclusion: In a cross-sectional analysis of patients with and without SAH, a cutoff point ≥ 6 by Youden´s statistics was predictive of those individuals with PWV ≥ 10m/s. The qualitative analysis determined the best cutoff point as ≥ 7 to predict PWV ≥ 10m/s. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-08-01T17:29:45Z 2022-08-01T17:29:45Z 2022-07-19 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/25704 |
url |
http://repositorio.ufsm.br/handle/1/25704 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Ciências da Saúde UFSM Programa de Pós-Graduação em Gerontologia Centro de Educação Física e Desportos |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Ciências da Saúde UFSM Programa de Pós-Graduação em Gerontologia Centro de Educação Física e Desportos |
dc.source.none.fl_str_mv |
reponame:Manancial - Repositório Digital da UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Manancial - Repositório Digital da UFSM |
collection |
Manancial - Repositório Digital da UFSM |
repository.name.fl_str_mv |
Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
atendimento.sib@ufsm.br||tedebc@gmail.com |
_version_ |
1805922043957346304 |