在不稳定的心痛中,高C-反应蛋白的独立预后值在不稳定的心痛中
E R Ferreirós1, C P Boissonnet, R Pizarro
1Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Circulation
|November 11, 1999
概括
不稳定的心痛患者的C-反应蛋白 (CRP) 水平预测了90天的风险. 医院出院时测量的CRP比入院时的CRP更强烈地预测不良结果,有助于风险分层.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 炎症 炎症是一种炎症.
背景情况:
- 越来越多的证据表明,C反应蛋白 (CRP) 在不稳定的心痛中具有预后重要性.
- 与其他标志物相比,CRP在不同治疗阶段的独立预测值仍然不清楚.
- 这项研究旨在评估血清CRP在不稳定性心痛患者的住院和90天预后意义.
研究的目的:
- 评估血清C-反应蛋白 (CRP) 在不稳定的心痛中的预后价值.
- 为了比较入院时的CRP水平与出院时的90天结果的预测能力.
- 为了确定CRP是否在这个患者群体中是一个独立的风险标志物.
主要方法:
- 分析了194名不稳定的胸痛患者的衍生 (n=105) 和验证 (n=89) 集.
- 血清CRP水平在入院,48小时和出院时进行测量.
- 接收机操作员曲线确定了不良结果的最佳CRP切断值为1.5 mg/dL.
主要成果:
- 没有发现入院CRP和住院结果之间的关联.
- 接受治疗的CRP,调整为临床因素,预测了90天的不良事件 (难治性心痛,心肌梗塞,死亡;HR1.9,P=0.002).
- 出院后的CRP是90天不良结果最强的独立预测因素 (HR 3.16,P=0.0001),在验证组中得到证实 (HR 3.3,P=0.0001).
结论:
- 反应性C蛋白 (CRP) 是一种显著的独立标志物,用于增加不稳定性心痛90天风险.
- 与入院水平相比,医院出院时的CRP水平为以后的结果提供了更好的预后价值.
- 放出CRP测量可以显著提高不稳定的胸痛患者的风险分层.
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