在接受TAVR的大动脉狭窄患者中,EASIX作为3年死亡率的预测因素
Mustafa Mousa Basha1, Baravan Al-Kassou2, Christopher Gestrich2
1Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. Mustafa.Basha@ukbonn.de.
概括
内皮激活和压力指数 (EASIX) 预测了跨导管大动脉置换 (TAVR) 患者的3年死亡率. 虽然显著,但EASIX对TAVR结果的预测能力低于NT-proBNP和热素T.
科学领域:
- 心脏病学 心脏病学
- 生物标志物研究 生物标志物研究
- 血管生物学 血管生物学
背景情况:
- 内皮功能障碍是大动脉狭窄 (AS) 进展的关键.
- 内皮激活和压力指数 (EASIX) 是一种潜在的死亡生物标志物.
- 在不同的临床场景中,EASIX可能具有预后价值.
研究的目的:
- 评估EASIX对接受TAVR的患者3年死亡率的预测能力.
- 确定程序前EASIX水平与TAVR后的长期结果之间的关联.
主要方法:
- 对1084名接受TAVR (2013-2021) 的严重AS患者进行了回顾性分析.
- 程序前的EASIX测量和优势切断点的Youden指数 (≥1.65).
- 卡普兰-梅尔和考克斯回归分析为3年所有原因死亡率预测.
主要成果:
- 较高的EASIX (≥1.65) 与显著更高的3年死亡率相关 (45.8%与27.7%,p<0.001).
- 在多变量分析中,EASIX独立预测死亡率 (HR=1.4,p=0.010).
- 与NT-proBNP (70.2%) 和热素T (69.8%) 相比,EASIX的预测准确性较低 (AUC为63.0%).
结论:
- 在TAVR患者中,EASIX是3年全因死亡率的重要预测因素.
- EASIX的预测性能被NT-proBNP和托罗邦素T所超越.
- 将EASIX与心脏生物标志物的结合可以改善风险分层,并为TAVR接受者提供个性化的护理.
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