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Heart:C反应蛋白在先天性心脏病成人中的预后价值

2020-10-16 MedSci原创 MedSci原创

Hs-CRP对死亡或HF的预后价值增加,超过NT-proBNP和hs-肌钙蛋白T。Hs-CRP在HF或死亡发生前升高,这些结果支持炎症在ACHD患者临床恶化中的作用。

高敏C反应蛋白(hs-CRP)与成人先天性心脏病(ACHD)的预后相关。但是,其预后价值是否超过B型利钠肽前体N端(NT-proBNP)或肌钙蛋白T尚未明确。近日,心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员分析了ACHD患者hs-CRP的时间演变以及hs-CRP与独立于NT-proBNP和肌钙蛋白T的不良临床结局之间的关系。

在这项前瞻性队列研究中,研究人员招募了602例ACHD患者(2011-2013年),这些患者均接受了基线和之后4年每年进行的血液采样。研究人员测量了受试者Hs-CRP、hs-肌钙蛋白T和NT-proBNP。该研究的主要终点包括死亡或心力衰竭(HF)。研究人员使用Cox回归和联合建模将hs-CRP水平与终点关联,并调整基线特征以及(重复的)hs-肌钙蛋白T和NT-proBNP的测量值。

在基线时,研究人员测量了591例患者的Hs-CRP水平,中位年龄为33岁,男性占58%,纽约心功能I级患者占90%,每位患者平均进行了4.3次测量。中位随访时间为5.9(IQR为5.3–6.3)年(99.2%患者完成),有69例患者发生了终点事件。较高的基线hs-CRP独立地与较高的死亡或心力衰竭风险相关(HR为1.36,95%CI为1.19至1.55)。Hs-CRP在死亡或HF之前随时间增加,并且重复的hs-CRP测量与终点相关,与重复测量的NT-proBNP和hs-肌钙蛋白T无关(HR为1.54,95%CI为1.24至1.98)。

由此可见,Hs-CRP对死亡或HF的预后价值增加,超过NT-proBNP和hs-肌钙蛋白T。Hs-CRP在HF或死亡发生前升高,这些结果支持炎症在ACHD患者临床恶化中的作用。

原始出处:

Laurie W Geenen.et al.Prognostic value of C-reactive protein in adults with congenital heart disease.heart.2020.http://creativecommons.org/licenses/by-nc/4.0/

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    2020-10-21 ms8281181061902252

    有用

    0

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    2020-10-18 zhaojie88
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    2020-10-18 huirong
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    2020-10-18 slcumt

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