Department of EICU, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui, China.
Department of Emergency General Ward, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui, China.
Clin Cardiol. 2021 Mar;44(3):401-406. doi: 10.1002/clc.23550. Epub 2021 Jan 26.
Indicators of adverse cardiovascular events in patients with acute carbon monoxide (CO) poisoning-induced myocardial injury have not yet been elucidated.
This study aimed at determining the risk factors for adverse cardiovascular events in patients with acute CO poisoning-induced myocardial injury.
We enrolled patients with moderate-to-severe acute CO poisoning-induced myocardial injury. Based on the occurrence of adverse cardiovascular events, the patients were assigned into event and non-event group. Binary logistic regression analysis was performed to analyze the potential risk factors for cardiovascular adverse events.
A total of 413 eligible patients were enrolled. Among them, 61 (14.8%) patients presented adverse cardiovascular events and were assigned to the event group while 352 patients were assigned to the non-event group. Univariate analysis revealed that cTnI, Lac, and NLR levels at admission and sST2 at day 3 in the event group were significantly higher compared to those in the non-event group. Subsequent multivariate analysis revealed that sST2 at day 3 and NLR at admission were independent risk factors for adverse cardiovascular events in patients with acute CO poisoning-induced myocardial injury. Finally, the sensitivity, specificity, and AUC of sST2 at day 3 combined with NLR for event prediction were 79.5%, 82.8%, and 0.858, respectively.
A combination of sST2 at day 3 and NLR is a potential predictor for the occurrence of adverse cardiovascular events in patients with acute CO poisoning-induced myocardial injury. Therefore, cardiovascular risk stratification should be taken into consideration, especially in patients with acute CO poisoning-induced myocardial injury.
急性一氧化碳（CO）中毒性心肌损伤患者的不良心血管事件指标尚未阐明。
本研究旨在确定急性 CO 中毒性心肌损伤患者不良心血管事件的危险因素。
我们纳入了中度至重度急性 CO 中毒性心肌损伤患者。根据不良心血管事件的发生情况，将患者分为事件组和非事件组。采用二元逻辑回归分析分析心血管不良事件的潜在危险因素。
共纳入 413 例符合条件的患者。其中，61 例（14.8%）患者出现不良心血管事件，归入事件组，352 例患者归入非事件组。单因素分析显示，事件组入院时 cTnI、Lac 和 NLR 水平以及第 3 天的 sST2 水平明显高于非事件组。进一步的多因素分析显示，第 3 天的 sST2 和入院时的 NLR 是急性 CO 中毒性心肌损伤患者不良心血管事件的独立危险因素。最后，第 3 天的 sST2 联合 NLR 对事件预测的敏感性、特异性和 AUC 分别为 79.5%、82.8%和 0.858。
第 3 天的 sST2 与 NLR 的联合是急性 CO 中毒性心肌损伤患者不良心血管事件发生的潜在预测指标。因此，应考虑进行心血管风险分层，特别是在急性 CO 中毒性心肌损伤患者中。
