非洲裔美国人第八因子水平的预后影响:来自与倾向匹配的美国多中心回顾分析的见解
Kerollos Abdelsayed1, Qasi Najah2, Ahmed Almahdy Mohamed3
1Heart Rhythm Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA.
Journal of thrombosis and thrombolysis
|May 29, 2025
概括
非洲裔美国人的高血凝因子VIII (FVIII) 水平与心血管事件和死亡率的风险增加有关. 这项研究强调了高FVIII在这个人群中的预后影响.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 流行病学 流行病学
背景情况:
- 高血凝因子VIII (FVIII) 水平在非洲裔美国人 (AAs) 中更为普遍.
- 这些高水平与血栓栓塞和心血管并发症的风险增加有关.
- 在AAs中高FVIII的预后意义仍未得到充分研究.
研究的目的:
- 研究非裔美国人的FVIII水平升高的预后影响.
- 为了比较AAs与FVIII> 200%的心血管结果,与50-200%相比.
主要方法:
- 使用了TrinetX数据库 (2005年8月 - 2019年8月).
- 员工倾向性得分匹配 (PSM) 以平衡队列之间的基线特征.
- 评估主要结果 (主要不良心血管事件 - MACE) 和探索性结果 (静脉血栓栓塞 - VTE,脑血管事件,心力衰竭 - HF,死亡率) 在指数FVIII后的五年内.
- 通过日志等级测试,卡普兰-梅尔曲线和考克斯回归进行了生存分析.
主要成果:
- 在PSM之后,每个队列中包括了3833名患者.
- 升高的FVIII与更高的5年MACE风险 (HR: 1.14),VTE (HR: 1.23),新发性HF (HR: 1.41) 和全因死亡率 (HR: 1.37) 相关.
- 经过对·维勒布兰德因子 (vWF) 和并发症进行调整后,与新发性HF的关联减弱,但死亡风险仍然很大 (HR: 1.53).
结论:
- 非洲裔美国人的FVIII水平升高与心血管不良结果的风险增加有关,包括新发性心力衰竭.
- 与高FVIII相关的死亡风险即使在多变量调整后仍然显著.
- 需要进一步的研究来探索FVIII在这些心血管疾病中的动态相互作用和潜在的因果作用.
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