N-终端亲B型尿素度,测试和与恶化心力衰竭事件的关联
Giulia Ferrannini1,2, Lina Benson1, Dominik Lautsch3
1Division of Cardiology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Norrbacka S1:02, SE-17176, Stockholm, Sweden.
ESC heart failure
|December 20, 2023
概括
在心力衰竭 (HF) 患者中,N-终端亲B型尿素 (NT-proBNP) 测试增加,特别是那些心力衰竭事件恶化的患者. 较高的NT-proBNP水平独立预测了这些事件的更高风险,表明了更广泛的实施效益.
科学领域:
- 心脏病学和心血管研究
- 生物标志物的发现和应用
- 医疗保健服务研究 医疗服务研究
背景情况:
- N-终端亲B型尿素 (NT-proBNP) 是心力衰竭 (HF) 管理中的一个关键生物标志物.
- 了解NT-proBNP测试的趋势和关联对于优化患者护理和预测不良事件至关重要.
- 之前的研究已经探讨了NT-proBNP水平,但时间趋势和与恶化HF事件的关联需要进一步调查.
研究的目的:
- 分析心力衰竭患者中NT-proBNP测试的时间趋势.
- 为了确定与NT-proBNP测试相关的患者特征.
- 检查NT-proBNP水平分布及其与恶化HF事件 (WHFE) 的相关性.
主要方法:
- 来自瑞典心力衰竭登记处 (SwedeHF) 的4424名心力衰竭患者的回顾性分析与斯德哥尔摩CREAtinine测量项目 (2011-2018) 相关.
- 评估NT-proBNP测试频率,患者特征和NT-proBNP水平变化 (稳定低,增加,减少,稳定高) 与指数日相比.
- 后勤回归模型用于确定临床因素,NT-proBNP测试和WHFE风险之间的关联.
主要成果:
- 随着时间的推移,NT-proBNP测试显著增加,到2018年达到55%,但在一半的高频人口中仍未得到充分利用.
- 经历HF事件恶化的患者 (WHFE) 与没有经历HF事件恶化的患者相比,测试频率几乎翻了一番,测试时间更短.
- 测试的独立预测因素包括WHFE,心率升高,利尿剂使用和保存的喷射分数;中位数NT-proBNP在WHFE患者中高出约3倍.
结论:
- 尽管使用越来越多,但NT-proBNP测试在心力衰竭治疗中仍然不是普遍的.
- 测试与WHFE和更严重疾病的特征有关,有助于差异诊断.
- 增加和稳定的高NT-proBNP水平独立地与WHFE的更高风险有关,这强调了更广泛的NT-proBNP实施的价值.
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