Franke Jennifer, Lindmark Andreas, Hochadel Matthias, Zugck Christian, Koerner Eva, Keppler Jeannette, Ehlermann Philipp, Winkler Ralph, Zahn Ralf, Katus Hugo A, Senges Jochen, Frankenstein Lutz
Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany,
Clin Res Cardiol. 2015 Apr;104(4):334-41. doi: 10.1007/s00392-014-0786-z. Epub 2014 Nov 6.
We performed a prospective multi-center study to assess gender-specific differences in the predictive value of the measured level of NT-proBNP and the calculated Heart Failure Survival Score (HFSS).
Baseline characteristics and follow-up data up to 5 years from 2,019 men and 530 women diagnosed with chronic heart failure (CHF) due to ischemic heart disease or dilated cardiomyopathy were prospectively compared. Death from any cause constituted the endpoint of the study. NT-proBNP was measured and HFSS calculated according to standard methods. Survival of men and women according to level of NT-proBNP and HFSS was analyzed in logistic regression models.
Median NT-proBNP level in men was 1,394 ng/l (IQR 516-3,406 ng/l) and 1,168 ng/l (IQR 444-2,830 ng/l) in women (p = n.s.). Median HFSS value was 8.4 (IQR 7.7-9.1) and 8.5 (8.0-9.1) in men and women, respectively. NT-proBNP levels and HFSS score correlated well with survival rates in both genders (p for interaction = 0.22 for NT-proBNP and 0.93 for HFSS). The all-cause death rates were similar in men and women.
Despite a number of gender-specific differences in CHF and the general predominance of men measured levels of NT-proBNP and HFSS score can be utilized for risk stratification with similar informative value in men and women.
我们进行了一项前瞻性多中心研究，以评估NT-proBNP测量水平和计算得出的心力衰竭生存评分（HFSS）在预测价值方面的性别差异。
对2019名男性和530名女性因缺血性心脏病或扩张型心肌病诊断为慢性心力衰竭（CHF）的基线特征和长达5年的随访数据进行前瞻性比较。任何原因导致的死亡构成研究终点。根据标准方法测量NT-proBNP并计算HFSS。在逻辑回归模型中分析男性和女性根据NT-proBNP水平和HFSS的生存率。
男性NT-proBNP水平中位数为1394 ng/l（四分位间距516 - 3406 ng/l），女性为1168 ng/l（四分位间距444 - 2830 ng/l）（p = 无统计学意义）。男性和女性的HFSS中位数分别为8.4（四分位间距7.7 - 9.1）和8.5（8.0 - 9.1）。NT-proBNP水平和HFSS评分与两性的生存率均密切相关（NT-proBNP交互作用p = 0.22，HFSS为0.93）。男性和女性的全因死亡率相似。
尽管在CHF方面存在一些性别差异，且男性在NT-proBNP测量水平上总体占优势，但HFSS评分可用于风险分层，在男性和女性中具有相似的信息价值。
