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不同的eGFR标志物和心血管风险预测

Maria Tydén¹, Gorav Batra^2,3, Bengt Fellström¹

¹Department of Medical Sciences, Renal Medicine, Uppsala University, Uppsala, Sweden.

Journal of internal medicine

|November 22, 2025

概括

在慢性冠状动脉综合征患者中,较低的估计淋巴球过率 (eGFR) 值,无论是基于cystatin C (eGFRcys) 还是基于肌素 (eGFRcr),都表明心血管风险较高. 基于Cystatin C的eGFR显示出与主要心血管不良事件的最强相关性.

科学领域:

腎臟病學 (nephrology) 是一種醫學.
心脏病学心脏病学
生物标志物生物标志物

背景情况:

功能障碍是增加心血管 (CV) 风险的重要因素.
准确评估功能对于患有慢性疾病的患者的风险分层至关重要.
将功能的不同标志物进行比较,例如基于囊素C (eGFRcys) 和基于肌素 (eGFRcr) 的估计膜过率,对于理解它们的预后影响至关重要.

研究的目的:

为了比较eGFRcys,eGFRcr及其比率 (eGFRcys/eGFRcr) 的预后值,预测主要心血管不良事件 (MACE) 和全因死亡率.
评估慢性冠状动脉综合征患者的EGFR比率超出单个EGFR测量的预后附加值.
评估大队伍中功能障碍标志物与心血管结果之间的关联.

主要方法:

通过启动达拉普拉迪布治疗试验稳定动脉硬性斑块的14513名患者的后期分析.
使用考克斯回归模型,研究了基线eGFRcys,eGFRcr和它们与MACE和全因死亡的比率之间的关联.
使用Harrell的C指数评估模型歧视,并使用新信息 (FNI) 分数增加预测价值.

主要成果:

较低的eGFRcys,eGFRcr和eGFR比率与MACE风险增加有关,主要是由心血管死亡驱动的.
与eGFRcr (eGFRcys调整后的HR 0.82) 相比,eGFRcys与MACE (调整后的HR 1.77) 的相关性更强.
经eGFRcr调整后,eGFR比率与更高的MACE风险 (HR1.99) 相关,具有显著的附加值 (FNI 54%),但经eGFRcys.调整后附加值有限.

结论:

在患有慢性冠状动脉综合征的患者中,降低EGFRcys,EGFRcr和EGFR比率与MACE和死亡风险增加有关.
在这个队列中,eGFRcys表现出与心血管事件的最强的预后关联.
eGFRcr和eGFR比率提供了超出eGFRcys.的有限的增量预测值.

关键词:

关键字关键字关键字关键字关键字心血管事件的发生.肌氨酸是什么意思肌氨酸是什么意思氨酸C 氨酸C 氨酸球膜过率是指球膜的过率死亡率死亡率

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