内皮细胞蛋白聚糖是慢性稳定型心力衰竭患者心力衰竭相关死亡率和住院率的独立预测因子。
Endocan Is an Independent Predictor of Heart Failure-Related Mortality and Hospitalizations in Patients with Chronic Stable Heart Failure.
机构信息
Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia.
Department of Vascular Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.
出版信息
Dis Markers. 2019 Apr 4;2019:9134096. doi: 10.1155/2019/9134096. eCollection 2019.
BACKGROUND
Heart failure (HF) is characterized by unfavorable prognosis. Disease trajectory of HF, however, may vary, and risk assessment of patients remains elusive. In our study, we sought to determine the prognostic impact of endocan-a novel biomarker of endothelial dysfunction and low-grade inflammation-in patients with heart failure.
METHODS
In outpatients with chronic HF, baseline values of endocan were determined and clinical follow-up for a minimum of 18 months obtained. A multivariate Cox proportional hazard model was built for HF-related death or hospitalization requiring inotropic support.
RESULTS
A total of 120 patients (mean age 71 years, 64% male, mean LVEF 36%) were included. During a mean follow-up of 656 ± 109 days, 50 patients (41.6%) experienced an event. On Cox multivariate analysis, endocan values emerged as an independent predictor of HF prognosis (HR, 1.471 CI 95% 1.183-1.829, = 0.001, for each 1 ng/mL increase) even after adjustment for age, gender, HF etiology, LVEF, NYHA class, NT-proBNP, and exercise tolerance.
CONCLUSIONS
Endocan is an independent predictor of HF-related events in chronic HF individuals and represents a promising tool for risk assessment of HF patients.
背景
心力衰竭（HF）的预后较差。然而，HF 的疾病进程可能存在差异，患者的风险评估仍难以捉摸。在我们的研究中，我们旨在确定内脂素-一种内皮功能障碍和低度炎症的新型生物标志物-对心力衰竭患者的预后影响。
方法
在慢性 HF 的门诊患者中，测定基线内脂素值，并获得至少 18 个月的临床随访。建立了一个多变量 Cox 比例风险模型，用于 HF 相关死亡或需要正性肌力支持的住院治疗。
结果
共纳入 120 例患者（平均年龄 71 岁，64%为男性，平均 LVEF 为 36%）。在平均 656±109 天的随访中，50 例（41.6%）发生了事件。在 Cox 多变量分析中，内脂素值是 HF 预后的独立预测因子（HR，1.471；95%CI 1.183-1.829；P=0.001，每增加 1ng/mL），即使在调整了年龄、性别、HF 病因、LVEF、NYHA 分级、NT-proBNP 和运动耐量后也是如此。
结论
内脂素是慢性 HF 个体中 HF 相关事件的独立预测因子，是 HF 患者风险评估的有前途的工具。
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