总胆红素在老年人心肌梗塞后提供预后信息
Dennis Winston T Nilsen1,2, Peder Langeland Myhre3,4, Svein Solheim3,5
1Department of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway.
Antioxidants (Basel, Switzerland)
|June 28, 2023
概括
较高的总胆红素水平可能表明心肌梗塞后心血管健康的预后更好. 低胆红素度与老年患者心血管不良事件和死亡风险的增加有关.
科学领域:
- 心脏病学 心脏病学
- 生物化学 生物化学
- 老年病的医生 老年病的医生
背景情况:
- 总 bilirubin 是一种强大的抗氧化剂,具有作为心血管疾病的预后指标的潜力.
- 了解心肌梗塞 (MI) 后胆红素的作用对于预测患者的结果至关重要.
研究的目的:
- 研究血清总胆红素水平与老年患者心脏病发作后发生重大不良临床事件 (MACE) 的发生之间的关联.
主要方法:
- 在881名老年患者 (70-82岁) 中测量了血清总 bilirubin.
- 对MACE (非致命性心脏病发作,再血管化,中风,心力衰竭住院治疗或全因死亡) 患者进行了长达2年的随访.
- 使用考克斯回归模型分析了胆红素四分位数与MACE风险之间的关联,并对共变量进行调整.
主要成果:
- 较高的总胆红素度与MACE风险降低有关 (HR为每日志单位增加0.67,p=0.032).
- 与较高的四分位数相比,低 bilirubin 四分位数 (<9 μmol/L) 的患者表现出明显更高的MACE 风险 (HR 1.61,p=0.002).
- 在对临床因素进行调整后,这种关联仍然存在 (HR 1.52,p=0.009).
结论:
- 低血清总胆红素水平 (<9μmol/L) 是老年患者中心血管不良事件和死亡率的重要风险因素.
- 总 bilirubin 在心血管疾病管理中可以作为一个有价值的预后生物标志物.
相关概念视频
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
204
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
204
01:30Acute Coronary Syndrome III: Diagnostic Studies
11
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
11
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
127
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
127
01:22Myocarditis IV: Nursing Management
13
Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
13
01:27Myocarditis II: Clinical Features and Diagnostic Tests
12
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
12
01:14Myocarditis III: Medical Management
9
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
9