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前白蛋白、氨基末端 B 型利钠肽原、心脏型脂肪酸结合蛋白和心肌肌钙蛋白 I 对老年心力衰竭患者预后及不良结局的预测价值。

Prognostic value of prealbumin, N-terminal pro-B-type natriuretic peptide, heart type fatty acid binding protein, and cardiac troponin I in elderly patients for heart failure and poor outcomes.

机构信息

Department of Cardiology, Jinchang Hospital of Integrated Traditional Chinese and Western Medicine, Jinchang, China.

Department of Cardiovascular Medicine, the Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, China.

出版信息

J Int Med Res. 2021 May;49(5):300060521999742. doi: 10.1177/0300060521999742.

Abstract

OBJECTIVES

This study aimed to investigate the prognostic value of serum prealbumin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), heart type fatty acid binding protein (hFABP), and cardiac troponin I (cTnI) for heart failure and cardiac death in elderly patients.

METHODS

We studied 426 consecutive patients with New York Heart Association classes I to IV who were recruited between February 2014 and 2018. Cardiac mortality was the primary end point. Receiver operator characteristic curves were created to analyze predictive values.

RESULTS

When prealbumin, NT-proBNP, hFABP, and cTnI were combined, the areas under the receiver operator characteristic curve reached 0.930 and 0.903 for heart failure and cardiac death, respectively. Prealbumin, NT-proBNP, hFABP, and cTnI levels changed differently during therapy in patients in different prognosis groups. These parameters improved in patients who did not develop major adverse cardiovascular events (MACEs), but were unchanged or deteriorated in patients with MACEs. Multivariate Cox regression analysis showed that these parameters were significant independent risk factors for MACEs and cardiac death.

CONCLUSIONS

Our study shows that serum prealbumin, NT-proBNP, hFABP, and cTnI levels are significant prognostic factors for elderly patients with poor cardiac function. These parameters are more accurate for prognosis when used together.

摘要

目的

本研究旨在探讨血清前白蛋白、N-末端脑利钠肽前体(NT-proBNP)、心脏型脂肪酸结合蛋白(hFABP)和心肌肌钙蛋白 I(cTnI)对老年心力衰竭和心脏死亡的预后价值。

方法

我们研究了 2014 年 2 月至 2018 年间连续招募的 426 名纽约心脏协会(NYHA)分级 I 至 IV 级的患者。心脏死亡率为主要终点。绘制受试者工作特征(ROC)曲线以分析预测价值。

结果

当将前白蛋白、NT-proBNP、hFABP 和 cTnI 结合起来时,ROC 曲线下面积分别达到 0.930 和 0.903,分别用于心力衰竭和心脏死亡。在不同预后组的患者中,治疗期间前白蛋白、NT-proBNP、hFABP 和 cTnI 水平的变化不同。这些参数在未发生主要不良心血管事件(MACE)的患者中得到改善,但在发生 MACE 的患者中则保持不变或恶化。多变量 Cox 回归分析表明,这些参数是 MACE 和心脏死亡的显著独立危险因素。

结论

我们的研究表明,血清前白蛋白、NT-proBNP、hFABP 和 cTnI 水平是心功能较差的老年患者的重要预后因素。这些参数一起使用时对预后更准确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2885/8165533/987b2e0630af/10.1177_0300060521999742-fig1.jpg

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