心力衰竭中的脏生物标志物:系统审查和元分析
Amudha Kumar1, Vignesh Chidambaram2, Harinivas Shanmugavel Geetha3
1Division of Cardiology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA.
JACC. Advances
|June 28, 2024
概括
血清囊素C和NGAL预测心力衰竭 (HF) 患者的不良结果. 这些脏生物标志物,包括KIM-1,对于预测HF的死亡率,住院和恶化功能 (WRF) 至关重要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 生物标志物研究 生物标志物研究
背景情况:
- 囊素C,中性粒细胞凝酶相关的卡林 (NGAL) 和损伤分子 (KIM) -1 是已知的心力衰竭 (HF) 风险分层的生物标志物.
- 由于这些生物标志物的应用和解释不一致,这些生物标志物的临床采用受到限制.
研究的目的:
- 为了研究血清囊素C,NGAL,KIM-1和急性和慢性HF患者的临床结果之间的关联.
- 评估这些生物标志物的死亡率,住院和功能恶化 (WRF) 的预测价值.
主要方法:
- 一项系统性审查和随机效应元分析,针对PubMed和EMBASE的同行评审的英语文章,截至2021年12月.
- 包括100篇涉及45428名患者的文章,以分析生物标志物与HF结局的关联.
- 使用漏斗图表评估出版偏差.
主要成果:
- 血清囊C的升高 (上三位数与下三位数) 与死亡率增加 (pHR:1.59) 以及死亡率和HF住院病例的复合 (pHR:1.49) 相关.
- 较高的血清NGAL水平表明死亡率增加 (pHR:2.91) 和复合结果 (HR:4.11).
- 血清和尿液NGAL预测了WRF (pHR分别为2.40和2.01),而尿液KIM-1预测了WRF (pHR:1.60),但没有其他结果. 观察到高度的异质性.
结论:
- 血清囊素C和血清NGAL是HF患者不良结果的独立预测剂.
- 血清和尿液NGAL是HF背景下恶化功能 (WRF) 的显著预测因素.
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