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对功能的调整改善了尿中血栓素代谢物的预后性能
Bruce A Barton1, Shari S Kronsberg1, Essa Hariri1,2
1University of Massachusetts Chan Medical School, Worcester, MA, United States.
Clinical chemistry
|February 28, 2024
概括
调整尿中血栓素B2代谢物 (TXB2-M) 以估计的淋巴细胞过率 (eGFR) 显著改善了对阿司匹林使用者和非使用者的长期死亡风险的评估. 这种增强的风险预测对于临床决策至关重要.
科学领域:
- 心血管研究研究心血管研究
- 生物标志物发现发现
- 功能评估 功能评估
背景情况:
- 通过尿中血素B2代谢物 (TXB2-M) 调整为肌素来衡量系统性血素A2生成,与死亡风险有关.
- 对于阿司匹林使用者和非使用者的最佳TXB2-M值需要定义.
- 调整TXB2-M以估计球过率 (eGFR) 对死亡风险评估的影响尚不清楚.
研究的目的:
- 为阿司匹林使用者和非使用者建立最佳的TXB2-M切割点.
- 为了评估TXB2-M对eGFR的调整是否改善死亡风险评估与单独的肌素调整相比.
主要方法:
- 用ELISA测量1363名阿司匹林使用者和1681名非使用者的尿液TXB2-M (弗雷明汉心脏研究).
- TXB2-M和TXB2-M/eGFR的切割点是使用逻辑等级统计学确定的.
- 通过考克斯的比例危险建模和受限制的平均存活时间来评估死亡风险.
- 105名心力衰竭的阿司匹林使用者队列中的外部验证.
主要成果:
- 与单独使用TXB2-M相比,优化的TXB2-M/eGFR切点显示出优越的全因和心血管/中风死亡风险歧视.
- TXB2-M/eGFR显示出更高的未调整危险比率和更大的差异限制平均存活时间.
- 这些发现在心力衰竭的阿司匹林使用者身上得到了外部验证.
结论:
- 调整尿液TXB2-M对eGFR显著增加了与长期死亡风险的关联.
- 这种调整改善了风险分层,无论阿司匹林的使用情况如何.
- 经eGFR调整的TXB2-M为死亡风险评估提供了更强大的生物标志物.
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