病标记物对心血管疾病风险预测的影响 当冠状动脉分数已知时
Joshua Barzilay1, Robert Trujillo2, Spencer Hansen2
1Division of Endocrinology, Kaiser Permanente of Georgia, and the Division of Endocrinology Emory University School of Medicine Atlanta GA USA.
Journal of the American Heart Association
|January 30, 2026
概括
蛋白尿,功能标志物,显著改善心力衰竭和总死亡率的预测,特别是在糖尿病患者. 尿中的白蛋白与肌素比率 (UACR) 也有助于预测死亡率.
科学领域:
- 心血管医学 心血管医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流行病学 流行病学
背景情况:
- 心血管风险计算器越来越多地包含功能标志物,如估计的膜过率 (eGFR) 和尿中的白蛋白与肌素比率 (UACR).
- 动脉样硬化多民族研究 (MESA) 计算器包括冠状动脉分数以及传统风险因素.
研究的目的:
- 评估eGFR和UACR的预测作用,包括二分断断点 (例如,白色素尿),用于冠心病,心血管疾病 (CVD) 结果和总死亡率.
- 评估这些脏标记物的增量预测值,当冠状动脉是已知的.
主要方法:
- 在6707名没有临床心血管疾病的参与者身上使用了Cox比例危险模型,并结合了冠状动脉度评分.
- 调整了对共变量的模型,并使用曲线下的面积评估了预测的变化.
- 检查预先指定的子组,包括年龄,性别,种族/种族和糖尿病状态.
主要成果:
- 尿中的白蛋白与肌素比率 (UACR) 和白蛋白尿显示与大多数结局有显著的关联.
- 专尿显著改善了心力衰竭和总死亡率的预测 (P<0.001).
- 在糖尿病患者中,UACR和白尿对所有结果以及65岁以上患者的许多结果进行了增强的预测.
结论:
- 当考虑冠状动脉时,白膜尿会提高心力衰竭的预测.
- 无论是UACR还是albuminuria,都提高了总死亡率的预测.
- UACR和白尿是糖尿病患者所有结果的有价值的预测指标.
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