血浆高敏C反应蛋白在肥厚型心肌病患者中的预后意义
Prognostic Significance of Plasma High-Sensitivity C-Reactive Protein in Patients With Hypertrophic Cardiomyopathy.
作者信息
Zhu Ling, Zou Yubao, Wang Yilu, Luo Xiaoliang, Sun Kai, Wang Hu, Jia Lei, Liu Yan, Zou Juan, Yuan Zuyi, Hui Rutai, Kang Lianming, Song Lei, Wang Jizheng
机构信息
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
出版信息
J Am Heart Assoc. 2017 Feb 2;6(2):e004529. doi: 10.1161/JAHA.116.004529.
BACKGROUND
Elevated high-sensitivity C-reactive protein (hsCRP) has been associated with increased risks of adverse outcomes of various cardiovascular diseases. The relationship between hsCRP and the prognosis of hypertrophic cardiomyopathy remains to be evaluated.
METHODS AND RESULTS
The study used an observational cohort methodology. A total of 490 patients were enrolled in the Fuwai Hospital from 2001 to 2011 and were followed for 3.7±2.0 years. According to the risk category of hsCRP, subjects in the high hsCRP group (>3.0 mg/L) had a higher risk of developing adverse events than the low hsCRP group (<1.0 mg/L): cardiovascular death (adjusted hazard ratios[HR] 5.41, 95% CI 1.96-14.93, P=0.001), all-cause mortality (adjusted HR 4.78, 95% CI 1.99-11.47, P<0.001), sudden cardiac death (adjusted HR 11.29, 95% CI 1.38-92.20, P=0.024), and heart failure-related death (adjusted HR 4.38, 95% CI 1.15-16.60, P=0.030). Similarly, the continuous variable of hsCRP was also an independent predictor for adverse outcomes: cardiovascular death (adjusted HR 1.15, 95% CI 1.06-1.25, P=0.001), all-cause mortality (adjusted HR 1.17, 95% CI 1.09-1.26, P<0.001), sudden cardiac death (adjusted HR 1.20, 95% CI 1.06-1.36, P=0.003), and heart failure-related death (adjusted HR 1.15, 95% CI 1.02-1.30, P=0.020).
CONCLUSIONS
Our results indicate that elevated plasma hsCRP is associated with increased risk for adverse outcomes in patients with hypertrophic cardiomyopathy.
背景
高敏C反应蛋白（hsCRP）升高与多种心血管疾病不良结局风险增加相关。hsCRP与肥厚型心肌病预后的关系仍有待评估。
方法与结果
本研究采用观察性队列研究方法。2001年至2011年期间，共有490例患者入选阜外医院，并随访3.7±2.0年。根据hsCRP风险类别，hsCRP高值组（>3.0mg/L）发生不良事件的风险高于低值组（<1.0mg/L）：心血管死亡（校正风险比[HR]5.41，95%CI 1.96-14.93，P=0.001）、全因死亡率（校正HR 4.78，95%CI 1.99-11.47，P<0.001）、心源性猝死（校正HR 11.29，95%CI 1.38-92.20，P=0.024）以及心力衰竭相关死亡（校正HR 4.38，95%CI 1.15-16.60，P=0.030）。同样，hsCRP连续变量也是不良结局的独立预测因素：心血管死亡（校正HR 1.15，95%CI 1.06-1.25，P=0.001）、全因死亡率（校正HR 1.17，95%CI 1.09-1.26，P<0.001）、心源性猝死（校正HR 1.20，95%CI 1.06-1.36，P=0.003）以及心力衰竭相关死亡（校正HR 1.15，95%CI 1.02-1.30，P=0.020）。
结论
我们的结果表明，血浆hsCRP升高与肥厚型心肌病患者不良结局风险增加相关。
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