在心力衰竭中估计尾肌肉质量的预后值,使用肌素/囊素C
Tsutomu Sunayama1, Yudai Fujimoto1, Yuya Matsue1
1Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
概括
一个新的生物标志物模型准确地预测了低尾骨肌肉质量指数 (ASMI) 心力衰竭患者的死亡风险. 这种方法,与传统的人类测量模型不同,识别出具有明显更高死亡风险的患者.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 代谢疾病 代谢疾病
背景情况:
- 患有肉症的心力衰竭 (HF) 表示预后不佳.
- 对于HF患者,需要简单的方法来评估尾骨肌肉质量指数 (ASMI).
- 一种新型模型使用人体测量数据和血清肌素与囊素C比率 (Cre/CysC) 估计ASMI.
研究的目的:
- 为了比较一种新型生物标志物模型的预后价值与用于估计HF患者ASMI的传统人类学模型.
- 确定每个模型所定义的低ASMI是否预测高频率患者的全因死亡率.
主要方法:
- 847名住院心力衰竭患者的回顾性队列研究.
- 使用人类学模型 (年龄,体重,身高) 和生物标志物模型 (年龄,体重,血红蛋白,Cre/CysC) 来估计ASMI.
- 主要结局是全因死亡率;用于分析的是Cox比例危险模型.
主要成果:
- 低ASMI患病率在模型之间有所不同 (53.4%的人类测量与39.1%生物标志物).
- 在诊断低ASMI (kappa = 0.57) 时,两种模型之间观察到不太一致.
- 根据生物标志物模型的低ASMI,但不是人类学模型,在调整后与所有原因死亡率的增加显著相关 (HR = 2.32,p=0.001).
结论:
- 低ASMI,估计由一个生物标志物模型结合Cre/CysC,是心力衰竭患者死亡率的显著预测因素.
- 传统的人类测量模型的ASMI估计没有保留该队列中死亡率的预后价值.
- 生物标志物模型提供了更准确的预后评估ASMI在心力衰竭.
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