手术前的D-二次体和结局在肌切除术后阻塞性多变性心肌病
Tao Lu1, Changsheng Zhu1, Hao Cui2
1Department of Adult Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
International journal of cardiology
|November 8, 2024
概括
升高的D-二聚合物水平预测,在因心肌缩症而接受隔膜肌切除术的患者中,死亡风险增加. 这一发现为改善患者管理和结果提供了有价值的预后标记.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 外科手术的结果
背景情况:
- 在接受隔膜肌切除术的高性心肌病 (HCM) 患者中,D-二聚体的预后价值尚未得到充分确立.
- 截面肌切除术是症状性HCM的关键干预措施,但预测长期结果仍然至关重要.
研究的目的:
- 为了研究D-二次体水平与接受隔膜肌切除术的患者的死亡率之间的关联.
- 为了确定D-二次体是否可以作为所有原因和心血管死亡率的预后生物标志物.
主要方法:
- 对728名接受隔膜肌切除术的患者 (2009-2018) 的回顾性分析.
- 分类D-二极体水平为三极体;使用考克斯回归和竞争性风险模型.
- 主要终点:全因死亡率;次要终点:心血管死亡率.
主要成果:
- 较高的D-二次体水平与年龄较大,女性性别和更严重的额头骨吐相关.
- 对于D-二次体,0.29 mg/L的最佳切线预测了5年死亡率.
- D-二次数>0.29 mg/L显著增加所有原因 (HR 3.12) 和心血管死亡率 (HR 3.29) 的风险,独立于其他因素.
- 包括D-二次体改善了死亡率预测模型.
结论:
- 在隔膜肌切除术后的患者中,D-二聚体是中长期全因和心血管死亡率的重要预测因子.
- 在这种患者群体中,D-二聚合物为风险分层提供了强大的,可访问的生物标志物.
- 这些发现支持将D-二聚体测试纳入接受手术的HCM患者的预后评估.
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