Hitsumoto Takashi
Hitsumoto Medical Clinic, 2-7-7, Takezakicyou, Shimonoseki City, Yamaguchi, 750-0025, Japan. Email:
Cardiol Res. 2018 Aug;9(4):231-238. doi: 10.14740/cr763w. Epub 2018 Aug 10.
Recent clinical studies have reported that impaired hemorheology is a significant cardiovascular risk factor, but there has been no prospective study of its relationship with cardiovascular events. The aim of this prospective study was to assess the efficacy of whole blood passage time (WBPT), measured by a microchannel array flow analyzer (MC-FAN), as a predictor of primary cardiovascular events in patients with traditional cardiovascular risk factors.
The study enrolled 1,134 outpatients with traditional cardiovascular risk factors but no history of cardiovascular events (438 men and 696 women; mean ± standard deviation age, 67 ± 11 years). Based on the value of WBPT, the patients were assigned to one of three groups: L (low, WBPT < 50 s; n = 499), M (medium, WBPT 50 - 70 s; n = 295), or H (high, WBPT > 70 s; n = 340). The utility of the WBPT as a predictor of primary cardiovascular events was evaluated.
During the follow-up period (median 81.9 months), major adverse cardiovascular events (MACE) occurred in 95 cases (L, 21 cases (4.2%); M, 24 cases (8.1%); H, 50 cases (14.7%); P < 0.001, log-rank test). In multivariate Cox regression analyses, the risk for MACE was significantly higher in group H than in group L (hazard ratio, 2.32; 95% confidence interval, 1.31 - 3.20; P < 0.01). A WBPT cut-off of 72.4 s yielded the largest area under the curve of 0.705 (95% confidence interval: 0.678 - 0.732), with a sensitivity of 51.7% and specificity of 85.4% for discriminating between those who did and did not experience MACE during the follow-up period.
This study showed that WBPT evaluated by a MC-FAN was a predictor of primary cardiovascular events in patients with traditional cardiovascular risk factors.
近期临床研究报告称血液流变学受损是一个重要的心血管危险因素，但尚未有关于其与心血管事件关系的前瞻性研究。这项前瞻性研究的目的是评估通过微通道阵列流动分析仪（MC-FAN）测量的全血通过时间（WBPT）作为传统心血管危险因素患者原发性心血管事件预测指标的有效性。
该研究纳入了1134例有传统心血管危险因素但无心血管事件病史的门诊患者（438例男性和696例女性；平均±标准差年龄，67±11岁）。根据WBPT值，将患者分为三组之一：L组（低，WBPT<50秒；n = 499）、M组（中，WBPT 50 - 70秒；n = 295）或H组（高，WBPT>70秒；n = 340）。评估了WBPT作为原发性心血管事件预测指标的效用。
在随访期间（中位时间81.9个月），95例患者发生了主要不良心血管事件（MACE）（L组，21例（4.2%）；M组，24例（8.1%）；H组，50例（14.7%）；P<0.001，对数秩检验）。在多变量Cox回归分析中，H组发生MACE的风险显著高于L组（风险比，2.32；95%置信区间，1.31 - 3.20；P<0.01）。WBPT截止值为72.4秒时，曲线下面积最大，为0.705（95%置信区间：0.678 - 0.732），在区分随访期间发生和未发生MACE的患者时，敏感性为51.7%，特异性为85.4%。
本研究表明，通过MC-FAN评估的WBPT是传统心血管危险因素患者原发性心血管事件的预测指标。
