Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan.
Nutrients. 2020 Oct 29;12(11):3311. doi: 10.3390/nu12113311.
The TCB index (triglycerides × total cholesterol × body weight), a novel simply calculated nutritional index based on serum triglycerides (TGs), serum total cholesterol (TC), and body weight (BW), was recently reported to be a useful prognostic indicator in patients with coronary artery disease. Thus, this study aimed to investigate the relationship between TCBI and long-term mortality in acute decompensated heart failure (ADHF) patients. Patients with a diagnosis of ADHF who were consecutively admitted to the cardiac intensive care unit in our institution from 2007 to 2011 were targeted. TCBI was calculated using the formula TG (mg/dL) × TC (mg/dL) × BW (kg)/1000. Patients were divided into two groups according to the median TCBI value. An association between admission TCBI and mortality was assessed using univariable and multivariable Cox proportional hazard analyses. Overall, 417 eligible patients were enrolled, and 94 (22.5%) patients died during a median follow-up period of 2.2 years. The cumulative survival rate with respect to all-cause, cardiovascular, and cancer-related mortalities was worse in patients with low TCBI than in those with high TCBI. In the multivariable analysis, although TCBI was not associated with cardiovascular and cancer mortalities, the association between TCBI and reduced all-cause mortality (hazard ratio: 0.64, 95% confidence interval: 0.44-0.94, = 0.024) was observed. We computed net reclassification improvement (NRI) when TCBI or Geriatric Nutritional Risk Index (GNRI) was added on established predictors such as hemoglobin, serum sodium level, and both. TCBI improved discrimination for all-cause mortality (NRI: 0.42, < 0.001; when added on hemoglobin and serum sodium level). GNRI can improve discrimination for cancer mortality (NRI: 0.96, = 0.002; when added on hemoglobin and serum sodium level). TCBI, a novel and simply calculated nutritional index, can be useful to stratify patients with ADHF who were at risk for worse long-term overall mortality.
TCB 指数(甘油三酯×总胆固醇×体重)是一种新的简单计算营养指数,基于血清甘油三酯(TGs)、血清总胆固醇(TC)和体重(BW),最近报道它是冠心病患者的一种有用的预后指标。因此,本研究旨在探讨 TCB 指数与急性失代偿性心力衰竭(ADHF)患者的长期死亡率之间的关系。该研究纳入了 2007 年至 2011 年期间连续入住我院心脏重症监护病房的 ADHF 患者。TCB 指数通过公式 TG(mg/dL)×TC(mg/dL)×BW(kg)/1000 计算得出。根据 TCB 指数的中位数将患者分为两组。采用单变量和多变量 Cox 比例风险分析评估入院时 TCB 指数与死亡率之间的关系。共有 417 名符合条件的患者入选,中位随访 2.2 年后有 94 名(22.5%)患者死亡。在所有原因、心血管和癌症相关死亡率方面,低 TCB 指数组患者的累积生存率均较差。多变量分析显示,尽管 TCB 指数与心血管和癌症死亡率无关,但 TCB 指数与全因死亡率降低相关(风险比:0.64,95%置信区间:0.44-0.94, = 0.024)。当将 TCB 指数或老年营养风险指数(GNRI)添加到血红蛋白、血清钠水平和两者组合等既定预测因子上时,我们计算了净重新分类改善(NRI)。TCB 指数提高了全因死亡率的区分能力(NRI:0.42,<0.001;当添加血红蛋白和血清钠水平时)。GNRI 可以提高癌症死亡率的区分能力(NRI:0.96, = 0.002;当添加血红蛋白和血清钠水平时)。TCB 指数是一种新的、简单计算的营养指数,可用于对 ADHF 患者进行分层,这些患者有发生更差长期总体死亡率的风险。