超尿路血症与非糖尿病心力衰竭患者的死亡率较高有关
Sergio Madureira1, Rita Gouveia1, Catarina Elias1
1Department of Internal Medicine, Unidade Local de Saúde de São João, Porto, PRT.
Cureus
|January 9, 2025
概括
高尿路血 (HU) 增加心力衰竭 (HF) 死亡风险,但仅在没有糖尿病 (DM) 的患者中. 对于患有DM的HF患者来说,高尿酸水平似乎不会影响生存结果.
科学领域:
- 心脏病学 心脏病学
- 代谢疾病 代谢疾病
- 临床研究 临床研究
背景情况:
- 高尿路血 (HU) 与心力衰竭 (HF) 风险增加和较差的结果有关.
- 患有糖尿病的患者表现出更高的HU流行率.
研究的目的:
- 调查HU在心力衰竭 (HF) 患者的预后意义.
- 评估是否存在糖尿病 (DM) 改变了HU对HF结果的影响.
主要方法:
- 对538名患有左心室缩功能障碍 (LVSD) 的门诊HF患者进行了回顾性队列研究.
- 随访至2021年1月,所有原因死亡率作为主要终点.
- 根据DM状态分层的考克斯回归分析,HU定义为尿酸 (UA) > 8.2 mg/dL.
主要成果:
- 40%的患者患有HU (UA>8.2 mg/dL).
- HU与75%的全因死亡风险增加有关 (HR:1.75;P=0.003).
- 这种关联在非DM患者中持续存在 (HR:1.70;P=0.007),但在DM患者中没有,DM和UA之间的相互作用是显著的 (P=0.04).
结论:
- 糖尿病 (DM) 影响慢性心力衰竭 (HF) 中高尿血 (HU) 的预后影响.
- 在没有DM的HF患者中,与正常UA水平相比,HU与全因死亡风险增加70%有关.
- 在DM的存在下,HU在HF的预后值似乎减少或改变.
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