血小板分布宽度与心力衰竭患者预后的关系。
Association between platelet distribution width and prognosis in patients with heart failure.
作者信息
Sato Yu, Yoshihisa Akiomi, Watanabe Koichiro, Hotsuki Yu, Kimishima Yusuke, Yokokawa Tetsuro, Misaka Tomofumi, Sato Takamasa, Kaneshiro Takashi, Oikawa Masayoshi, Kobayashi Atsushi, Takeishi Yasuchika
机构信息
Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan.
出版信息
PLoS One. 2020 Dec 29;15(12):e0244608. doi: 10.1371/journal.pone.0244608. eCollection 2020.
BACKGROUND
The prognostic impact of platelet distribution width (PDW), which is a specific marker of platelet activation, has been unclear in patients with heart failure (HF).
METHODS AND RESULTS
We conducted a prospective observational study enrolling 1,746 hospitalized patients with HF. Patients were divided into tertiles based on levels of PDW: 1st (PDW < 15.9 fL, n = 586), 2nd (PDW 15.9-16.8 fL, n = 617), and 3rd (PDW ≥ 16.9, n = 543) tertiles. We compared baseline patients' characteristics and post-discharge prognosis: all-cause death; cardiac death; and cardiac events. The 3rd tertile showed the highest age and levels of B-type natriuretic peptide compared to other tertiles (1st, 2nd, and 3rd tertiles; age, 69.0, 68.0, and 70.0 years old, P = 0.038; B-type natriuretic peptide, 235.2, 171.9, and 241.0 pg/mL, P < 0.001). Left ventricular ejection fraction was equivalent among the tertiles. In the Kaplan-Meier analysis, rates of all endpoints were the highest in the 3rd tertile (log-rank P < 0.001, respectively). The Cox proportional hazard analysis revealed that the 3rd tertile was associated with adverse prognosis (all-cause death, hazard ratio [HR] 1.716, P < 0.001; cardiac death, HR 1.919, P < 0.001; cardiac event, HR 1.401, P = 0.002).
CONCLUSIONS
High PDW is a novel predictor of adverse prognosis in patients with HF.
背景
血小板分布宽度（PDW）作为血小板活化的一项特定标志物，其对心力衰竭（HF）患者预后的影响尚不清楚。
方法与结果
我们开展了一项前瞻性观察性研究，纳入了1746例因心力衰竭住院的患者。根据PDW水平将患者分为三个三分位数组：第一组（PDW < 15.9 fL，n = 586）、第二组（PDW 15.9 - 16.8 fL，n = 617）和第三组（PDW≥16.9，n = 543）。我们比较了患者的基线特征和出院后的预后情况：全因死亡、心源性死亡和心脏事件。与其他三分位数组相比，第三组患者的年龄和B型利钠肽水平最高（第一组、第二组和第三组；年龄分别为69.0岁、68.0岁和70.0岁，P = 0.038；B型利钠肽分别为235.2、171.9和241.0 pg/mL，P < 0.001）。三分位数组间左心室射血分数相当。在Kaplan-Meier分析中，所有终点事件的发生率在第三组中最高（对数秩检验P均< 0.001）。Cox比例风险分析显示，第三组与不良预后相关（全因死亡，风险比[HR] 1.716，P < 0.001；心源性死亡，HR 1.919，P < 0.001；心脏事件，HR 1.401，P = 0.002）。
结论
高血小板分布宽度是心力衰竭患者不良预后的一种新的预测指标。
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