Viborg-screeningsprogramma verlaagt 5-jaarssterfte bij 67-jarigen
Het Deense Viborg Screening Program nodigde alle 67-jarigen uit voor populatiebrede screening op carotisplaque, perifere arteriële vaatziekte, abdominale aorta-aneurysma, hypertensie, hartritmestoornissen of -ischemie en diabetes.
Onder 5412 uitgenodigden versus 16.236 gematchte controles was de 5-jaars all-cause mortaliteit significant lager (6,9% vs 8,9%; HR 0,76; NNI 49 om één leven te redden). Het effect was zichtbaar bij beide geslachten en het sterkst bij personen zonder voorafgaande cardiovasculaire ziekte (HR 0,70).
Major adverse limb events daalden ook (HR 0,70).
Abstract (original)
BACKGROUND AND AIMS: Cardiovascular screening has been shown to reduce mortality in trials involving men. This study evaluated the effect of cardiovascular screening in both sexes, with all-cause mortality as the primary outcome. METHODS: The Viborg Screening Program, a prospective, population-based study in Denmark, in which the intervention consisted of inviting all 67-year olds to screening for carotid plaque, lower extremity artery disease, abdominal aortic aneurysm, hypertension, cardiac arrhythmia/ischaemia, and diabetes mellitus. This cohort included invitees from the first 5 years (2014-2019). Controls were 67-year olds without screening access. Effects were evaluated using propensity score matching (1:3 ratio, nearest-neighbour matching) and analysed using Cox proportional hazards models under the intention-to-invite principle. Sex-stratified analyses of all-cause mortality were conducted post hoc. RESULTS: Among 5505 invitees, three died before inclusion and 4602 participated (83.6%). Ninety individuals lacked registry information. After matching, 5412 invitees and 16 236 controls were included. During a median follow-up of 5.8 years, 372 (6.9%) invitees and 1444 (8.9%) controls died [hazard ratio (HR) 0.76, 95% confidence interval (CI) 0.68-0.85; P < .001]. The number needed to invite to save one life was 49. The HR for cardiovascular mortality was 0.76 (95% CI 0.56-1.03), for major adverse cardiovascular events 1.10 (95% CI 1.01-1.19), and for major adverse limb events 0.70 (95% CI 0.50-0.98). All-cause mortality HRs were 0.73 (95% CI 0.63-0.84) for men, 0.82 (95% CI 0.68-0.98) for women, 0.70 (95% CI 0.61-0.80) for those without prior cardiovascular disease (CVD), and 0.97 (95% CI 0.78-1.21) for those with prior CVD. CONCLUSIONS: Multi-modality non-invasive cardiovascular screening reduced 5-year all-cause mortality among 67-year olds, also when stratified by sex. Prioritizing individuals without known CVD may enhance population-level impact.
Dit artikel is een samenvatting van een publicatie in European heart journal. Voor het volledige artikel, alle details en referenties verwijzen wij u naar de oorspronkelijke bron.
Lees het volledige artikelDOI: 10.1093/eurheartj/ehag309