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C 反应蛋白与稳定性冠心病患者全因死亡率:基于回顾性队列研究的二次分析。

C-Reactive Protein and All-Cause Mortality in Patients with Stable Coronary Artery Disease: A Secondary Analysis Based on a Retrospective Cohort Study.

机构信息

Emergency Department, The People's Hospital of Longhua, Shenzhen, Guangdong, China (mainland).

The People's Hospital of Longhua, Shenzhen, Guangdong, China (mainland).

出版信息

Med Sci Monit. 2019 Dec 21;25:9820-9828. doi: 10.12659/MSM.919584.

DOI:10.12659/MSM.919584
PMID:31863701
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6937905/
Abstract

BACKGROUND The association between C-reactive protein (CRP) and all-cause mortality (ACM) in patients with stable coronary artery disease (CAD) is unclear. Therefore, the aim of the present study was to explore the correlation between CRP and ACM in stable CAD patients. MATERIAL AND METHODS This study was a secondary analysis. Between October 2014 and October 2017, 196 patients aged 43 to 98 years who had a first diagnosis of stable CAD were recruited into this study. We divided the patients into 4 groups (Quartile 1: 0.01-0.03 mg/dL; Quartile 2: 0.04-0.11 mg/dL; Quartile 3: 0.12-0.33 mg/dL; and Quartile 4: 0.34-9.20 mg/dL) according to the concentration of CRP. The indicator surveyed in this research was ACM. RESULTS During a median follow-up of 783 days, ACM occurred in 18 patients, with a mortality rate of 9.18% (18/196). Univariate analysis showed that elevated CRP was closely related to ACM in stable CAD patients (P<0.005). After controlling for potential confounding factors by multivariate logistic regression analysis, this relationship still existed. Pearson correlation analysis showed that elevated CRP log10 transform was associated with LVEF (r=-0.1936, P=0.0067). Receiver operating characteristic (ROC) curve analysis showed that the optimal concentration of CRP for the diagnosis of ACM was 0.345, and the area under the curve (AUC) was 0.735. CONCLUSIONS Elevated CRP is associated with ACM in stable CAD patients, and the best diagnostic threshold is 0.345.

摘要

背景

在稳定性冠状动脉疾病(CAD)患者中,C 反应蛋白(CRP)与全因死亡率(ACM)之间的关系尚不清楚。因此,本研究旨在探讨 CRP 与稳定性 CAD 患者 ACM 之间的相关性。

材料和方法

本研究为二次分析。2014 年 10 月至 2017 年 10 月,共纳入 196 例年龄 43 至 98 岁首次诊断为稳定性 CAD 的患者。根据 CRP 浓度将患者分为 4 组(第 1 四分位数:0.01-0.03mg/dL;第 2 四分位数:0.04-0.11mg/dL;第 3 四分位数:0.12-0.33mg/dL;第 4 四分位数:0.34-9.20mg/dL)。本研究的观察指标为 ACM。

结果

在中位随访 783 天期间,18 例患者发生 ACM,死亡率为 9.18%(18/196)。单因素分析显示,CRP 升高与稳定性 CAD 患者的 ACM 密切相关(P<0.005)。多变量 logistic 回归分析校正潜在混杂因素后,这种关系仍然存在。Pearson 相关分析显示,CRP log10 转化与左心室射血分数(LVEF)呈负相关(r=-0.1936,P=0.0067)。ROC 曲线分析显示,CRP 诊断 ACM 的最佳浓度为 0.345,曲线下面积(AUC)为 0.735。

结论

CRP 升高与稳定性 CAD 患者的 ACM 相关,最佳诊断阈值为 0.345。

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