尿,功能,和心脏衰竭的临床结果与保存的喷射小部分心脏衰竭
Brendon L Neuen1, Muthiah Vaduganathan2, Brian L Claggett3
1Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA; The George Institute for Global Health, University of New South Wales, Sydney, Australia; Department of Renal Medicine, Royal North Shore Hospital, Sydney, Australia.
JACC. Heart failure
|October 4, 2024
概括
N-终端亲B型尿素 (NT-proBNP) 预测心力衰竭患者的不良结果较高,功能受损. 慢性病 (CKD) 患者中较高的NT-proBNP水平不应被忽视.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 生物标志物研究 生物标志物研究
背景情况:
- N-终端亲B型尿酸 (NT-proBNP) 是心力衰竭的关键生物标志物.
- 慢性病 (CKD) 中NT-proBNP的升高复杂化了跨eGFR水平的风险评估.
研究的目的:
- 评估NT-proBNP与心脏衰竭患者心血管和死亡结果的关联.
- 通过基线功能 (eGFR) 来分层这些关联.
主要方法:
- 在四项主要心力衰竭试验 (I-PRESERVE,TOPCAT,PARAGON,DELIVER) 中对14831名参与者的聚合分析.
- 断片线性回归评估了NT-proBNP和eGFR的关系.
- 多变量Cox和Poisson模型评估了NT-proBNP与整个eGFR层的结果的关联.
主要成果:
- NT-proBNP水平与eGFR相反相关,随着eGFR的下降,显著增加.
- 每次NT-proBNP的翻倍都与主要结果 (心力衰竭住院或心血管死亡) 的风险增加37%相关,在eGFR类别中一致.
- 对于等效的初级结局发病率,在EGFR<45mL/min/1.73m2的患者中,NT-proBNP水平比EGFR≥60mL/min/1.73m2的患者低2.5-3.5倍.
结论:
- 给定的NT-proBNP度表明,心力衰竭患者和功能受损患者的不良结果绝对风险要高得多.
- 发现挑战了为慢性病患者提出的更高NT-proBNP参考范围.
- 降低功能不应成为忽视心力衰竭中NT-proBNP水平升高的原因.
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