Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, No.33 Wenyi Road, Shenhe District, 110016, Shenyang, China.
Department of Bone and Soft Tissue Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, 110042, Shenyang, China.
Herz. 2021 Sep;46(Suppl 2):243-252. doi: 10.1007/s00059-020-04993-1. Epub 2020 Oct 21.
The aim of this study was to evaluate the prognostic value of a novel scoring system, based on D‑dimer, total cholesterol, high-sensitivity cardiac troponin T (hs-cTnT), and serum albumin levels, in patients with heart failure.
A total of 221 patients diagnosed with heart failure between May 2016 to January 2020 were enrolled in this retrospective study. The prognostic significance of the biomarkers D‑dimer, total cholesterol, hs-cTnT, and serum albumin was determined with univariate and multivariate Cox proportional hazard models. A novel prognostic score based on these predictors was established. The Kaplan-Meier method and log-rank test were used to compare the adverse outcomes of patients in different risk groups.
Results from univariate and multivariate analyses showed that high D‑dimer, low serum albumin, high hs-cTnT, and low total cholesterol levels were independent prognostic factors for adverse outcomes (D-dimer >0.63 mg/l, HR = 1.84, 95% CI = 1.16-2.94, p = 0.010; serum albumin >34 g/l, HR = 0.67, 95% CI = 0.45-0.99, p = 0.046; hs-cTnT >24.06 pg/ml, HR = 1.65, 95% CI = 1.08-2.53, p = 0.020; total cholesterol >3.68 mmol/l, HR = 0.63, 95% CI = 0.43-0.92, p = 0.017). Moreover, all the patients were stratified into low-risk or high-risk group according to a scoring system based on these four markers. Kaplan-Meier analyses demonstrated that patients in the high-risk group were more prone to having adverse outcomes compared with patients in the low-risk group.
D‑dimer, total cholesterol, hs-cTnT, and serum albumin levels were independent prognostic factors in the setting of heart failure. A novel and comprehensive scoring system based on these biomarkers is an easily available and effective tool for predicting the adverse outcomes of patients with heart failure.
本研究旨在评估一种基于 D-二聚体、总胆固醇、高敏心肌肌钙蛋白 T（hs-cTnT）和血清白蛋白水平的新型评分系统在心力衰竭患者中的预后价值。
本回顾性研究共纳入 2016 年 5 月至 2020 年 1 月期间诊断为心力衰竭的 221 例患者。采用单因素和多因素 Cox 比例风险模型确定生物标志物 D-二聚体、总胆固醇、hs-cTnT 和血清白蛋白的预后意义。基于这些预测因素建立了一种新的预后评分系统。采用 Kaplan-Meier 法和对数秩检验比较不同风险组患者的不良结局。
单因素和多因素分析结果显示，D-二聚体升高、血清白蛋白降低、hs-cTnT 升高和总胆固醇降低是不良预后的独立预测因素（D-二聚体>0.63mg/l，HR=1.84，95%CI=1.16-2.94，p=0.010；血清白蛋白>34g/l，HR=0.67，95%CI=0.45-0.99，p=0.046；hs-cTnT>24.06pg/ml，HR=1.65，95%CI=1.08-2.53，p=0.020；总胆固醇>3.68mmol/l，HR=0.63，95%CI=0.43-0.92，p=0.017）。此外，根据基于这四个标志物的评分系统，将所有患者分为低危或高危组。Kaplan-Meier 分析表明，高危组患者较低危组患者更易发生不良结局。
D-二聚体、总胆固醇、hs-cTnT 和血清白蛋白水平是心力衰竭患者的独立预后因素。基于这些生物标志物的新型综合评分系统是一种简单可行且有效的预测心力衰竭患者不良结局的工具。
