在患有急性ST段升高心肌梗塞的患者中,对N终端亲B型尿素和C反应蛋白测试的预后值
Ioana Mihaela Dregoesc1,2,3, Dana Cramariuc4, Tom Wilsgaard5
1"Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania.
在ST段升高心肌梗塞 (STEMI) 幸存者中,N终端亲B型尿素 (NT-proBNP) 预测死亡率,无论左心室喷射分数 (LVEF). 仅在LVEF降低的患者中,C-反应蛋白 (CRP) 与死亡率有关.
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
- 临床结果 临床结果
背景情况:
- 急性ST段升高心肌梗塞 (STEMI) 需要有效的风险分层,超出左心室喷射率 (LVEF).
- N-终端B型亲尿素 (NT-proBNP) 和C反应蛋白 (CRP) 是对STEMI患者风险评估的潜在生物标志物.
研究的目的:
- 评估NT-proBNP,CRP和急性STEMI患者全因死亡率之间的关联.
- 为了确定这些生物标志物是否与单独的LVEF相比改善了风险分层.
主要方法:
- 一项前性,观察性队列研究,对566名患有重流性急性STEMI的患者进行了观察.
- 测量了NT-proBNP和CRP水平,并在平均39个月的随访期间评估结果.
- 统计分析评估了与LVEF相关的生物标志物与死亡率的关联.
主要成果:
- 无论LVEF如何,NT-proBNP与死亡率显著相关 (p<0.001对于LVEF<50%,p=0.004对于LVEF≥50%).
- 只有在LVEF<50% (HR1.55,p=0.003) 的患者中,CRP与死亡率相关.
- 与单独使用LVEF (AUC 0.592) 相比,NT-proBNP改善了保留LVEF (AUC 0.753) 的患者的风险分层.
结论:
- 在稳定的STEMI幸存者中,NT-proBNP是中期死亡率的有价值的独立预测因素.
- CRP与死亡率的关联仅限于LVEF降低的患者.
- 在STEMI患者中,NT-proBNP测试增强了风险分层,特别是那些保持LVEF的患者.
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