Wang Wei, Wang Chun-Song, Ren Dong, Li Tai, Yao Heng-Chen, Ma Sheng-Jun
Department of Cardiology, Liaocheng People's Hospital Affiliated to Shandong University and Clinical School of Taishan Medical University Department of Cardiology, the Third People's Hospital of Liaocheng Department of Cardiac Surgery, Liaocheng People's Hospital Affiliated to Shandong University and Clinical School of Taishan Medical University, Liaocheng, People's Republic of China.
Medicine (Baltimore). 2018 Jul;97(30):e11740. doi: 10.1097/MD.0000000000011740.
The aim of this study is to evaluate if low prealbumin levels on admission predict subsequent adverse cardiac events in patients hospitalized with acute coronary syndrome (ACS).We designed a cohort study and enrolled 610 consecutive patients with ACS from whom venous blood for serum prealbumin measurement was drawn immediately upon hospital admission. Patients were classified in two groups according to prealbumin level: "normal" prealbumin levels (≥17 mg/dL, n=413) and "low" prealbumin (<17 mg/dL, n = 197). In-hospital adverse cardiac events were death, acute heart failure, reinfarction, and cardiogenic shock. Univariate and multivariable analyses were applied to evaluate the prediction value of low prealbumin.The incidence of in hospital adverse cardiac events is 10.8%. The proportion of adverse cardiac events was significantly higher in low prealbumin group as compared with normal prealbumin group (20.8% versus 6.1%, P < .001). Univariate analysis indicates that low prealbumin levels can predict in hospital adverse cardiac events (odds ratio [OR]: 0.834, 95% confidence interval [CI]: 0.785-0.886, P < .001). Multivariable analysis shows that low prealbumin level was an independent predictor for in hospital adverse cardiac events (adjusted OR: 0.918, 95% CI: 0.848-0.993, P = .033). Other independent predictors were lower in average hemoglobin level and Killip class II-IV on admission.Therefore, lower serum prealbumin levels on admission can independently predicts subsequent in hospital major adverse cardiac events in patients with ACS.
本研究的目的是评估急性冠状动脉综合征（ACS）住院患者入院时血清前白蛋白水平低是否可预测随后发生的不良心脏事件。我们设计了一项队列研究，纳入了610例连续的ACS患者，入院时立即采集静脉血测定血清前白蛋白。根据前白蛋白水平将患者分为两组：“正常”前白蛋白水平（≥17mg/dL，n = 413）和“低”前白蛋白水平（<17mg/dL，n = 197）。住院期间的不良心脏事件包括死亡、急性心力衰竭、再梗死和心源性休克。采用单因素和多因素分析来评估低前白蛋白的预测价值。住院期间不良心脏事件的发生率为10.8%。低前白蛋白组不良心脏事件的比例显著高于正常前白蛋白组（20.8%对6.1%，P <.001）。单因素分析表明，低前白蛋白水平可预测住院期间的不良心脏事件（比值比[OR]：0.834，95%置信区间[CI]：0.785 - 0.886，P <.001）。多因素分析显示，低前白蛋白水平是住院期间不良心脏事件的独立预测因素（校正OR：0.918，95%CI：0.848 - 0.993，P = 0.033）。其他独立预测因素为入院时平均血红蛋白水平较低和Killip分级为II - IV级。因此，入院时较低的血清前白蛋白水平可独立预测ACS患者随后发生的住院期间主要不良心脏事件。
