在急性心力衰竭患者中长期累积高敏感性C反应蛋白和死亡率
Lihua Zhang1, Guangda He1, Xiqian Huo1
1National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People's Republic of China.
长期增加的累积高灵敏性C反应蛋白 (hsCRP) 水平表明,心力衰竭住院患者的预后更差. 重复测量hsCRP可以帮助识别高风险死亡人群.
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:
- 高敏感性C反应蛋白 (hsCRP) 的升高与住院心力衰竭患者的治疗结果较差有关.
- 在心力衰竭中长期累积hsCRP水平的预后意义尚不清楚.
研究的目的:
- 研究因心力衰竭住院患者长期累积hsCRP水平与死亡率之间的关联.
- 为了确定重复hsCRP测量是否改善心力衰竭患者的风险分层.
主要方法:
- 连续招募1281名心力衰竭患者,在入院时测量hsCRP,在出院后1个月和12个月.
- 在随访期间使用四分位数和高水平 (0-3倍) 的频率评估长期累积hsCRP.
- 多变量考克斯回归模型被用来分析累积hsCRP与所有原因死亡率之间的关系,平均时间为4.8年.
主要成果:
- 累积hsCRP水平较高的四分位数与增加的死亡风险显著相关 (Q4的HR与Q1:2.38).
- 患有更频繁升高hsCRP水平的患者 (2或3倍) 与0倍 (HR为3倍:2.80) 患者相比,死亡风险明显更高.
- 在增加累积hsCRP负担和死亡率之间观察到剂量反应关系.
结论:
- 长期累积hsCRP水平的增加是急性心力衰竭住院患者情况更差的重要预测因素.
- 序列hsCRP测量提供了有价值的预后信息,帮助临床医生识别高死亡风险的患者.
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