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预后营养指数作为预测围产期心肌病患者预后的新标志物。

Prognostic nutritional index as a novel marker for prediction of prognosis in patients with peripartum cardiomyopathy.

作者信息

Tak Bahar Tekin, Cay Serkan, Pamukcu Hilal Erken, Ekizler Firdevs Aysenur, Kafes Habibe, Cetin Elif Hande Ozcan, Ulvan Nedret, Ozeke Ozcan, Ozcan Firat, Topaloglu Serkan, Aras Dursun

机构信息

Department of Cardiology, University of Health Sciences, Ankara City Hospital.

Department of Cardiology, Dişkapi Education and Research Hospital, Health Sciences University, Ankara, Turkey.

出版信息

Medicine (Baltimore). 2020 Mar;99(11):e19524. doi: 10.1097/MD.0000000000019524.

Abstract

The clinical significance of poor nutritional status in patients with peripartum cardiomyopathy (PPCM) is not clearly understood. Prognostic nutritional index (PNI) is a simple nutritional assessment tool, which was first demonstrated to be valuable in patients with colorectal surgeries. We aimed to investigate the predictive value of PNI in patients with PPCM.A total of 92 patients diagnosed with PPCM were enrolled in this study. PNI was calculated using the following formula: 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count. The primary endpoint was defined as composite adverse cardiac events that included cardiac death or hospitalization due to worsening heart failure (HF). Cardiac death, hospitalization due to worsening HF, and persistent left ventricular (LV) systolic dysfunction were evaluated, respectively, as secondary endpoints.Primary composite endpoint was higher in the lower PNI group. After adjusting for other risk factors, PNI was found to be as an independent predictor of primary composite endpoint (odds ratio 0.805; 95% confidence interval 0.729-0.888; P < .001). In addition, PNI was significantly associated with secondary endpoints; persistent LV systolic dysfunction as well as cardiac death.This study identified nutritional status assessed by the PNI seems to be a novel predictor of adverse cardiovascular outcomes in patients with PPCM.

摘要

围产期心肌病(PPCM)患者营养状况不佳的临床意义尚不清楚。预后营养指数(PNI)是一种简单的营养评估工具,最初被证明在接受结直肠手术的患者中具有价值。我们旨在研究PNI对PPCM患者的预测价值。

本研究共纳入92例诊断为PPCM的患者。PNI采用以下公式计算:10×血清白蛋白值(g/dL)+0.005×总淋巴细胞计数。主要终点定义为复合不良心脏事件,包括心源性死亡或因心力衰竭(HF)恶化而住院。分别将心源性死亡、因HF恶化而住院以及持续性左心室(LV)收缩功能障碍评估为次要终点。

较低PNI组的主要复合终点更高。在调整其他危险因素后,发现PNI是主要复合终点的独立预测因素(比值比0.805;95%置信区间0.729-0.888;P<0.001)。此外,PNI与次要终点显著相关;持续性LV收缩功能障碍以及心源性死亡。

本研究表明,通过PNI评估的营养状况似乎是PPCM患者不良心血管结局的一种新的预测指标。

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