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经 TAVI 治疗后的重度主动脉瓣狭窄患者的全身免疫炎症指数对主要不良心脏事件和死亡率的预后价值。

Prognostic Value of Systemic Immune-Inflammation Index for Major Adverse Cardiac Events and Mortality in Severe Aortic Stenosis Patients after TAVI.

机构信息

Department of Cardiology, Haseki Training and Research Hospital, University of Health Sciences, 34130 Istanbul, Turkey.

Department of Cardiology, Sultan II. Abdülhamid Han Training and Research Hospital, University of Health Sciences, 34668 Istanbul, Turkey.

出版信息

Medicina (Kaunas). 2021 Jun 8;57(6):588. doi: 10.3390/medicina57060588.

Abstract

In this study, we aimed to evaluate whether the systemic immune-inflammation index (SII) has a prognostic value for major adverse cardiac events (MACEs), including stroke, re-hospitalization, and short-term all-cause mortality at 6 months, in aortic stenosis (AS) patients who underwent transcatheter aortic valve implantation (TAVI). A total of 120 patients who underwent TAVI due to severe AS were retrospectively included in our study. The main outcome of the study was MACEs and short-term all-cause mortality at 6 months. The SII was found to be higher in TAVI patients who developed MACEs than in those who did not develop them. Multivariate Cox regression analysis revealed that the SII (HR: 1.002, 95%CI: 1.001-1.003, < 0.01) was an independent predictor of MACEs in AS patients after TAVI. The optimal value of the SII for MACEs in AS patients following TAVI was >1.056 with 94% sensitivity and 96% specificity (AUC (the area under the curve): 0.960, < 0.01). We noted that the AUC value of SII in predicting MACEs was significantly higher than the AUC value of the C-reactive protein (AUC: 0.960 vs. AUC: 0.714, respectively). This is the first study to show that high pre-procedural SII may have a predictive value for MACEs and short-term mortality in AS patients undergoing TAVI.

摘要

在这项研究中,我们旨在评估系统性免疫炎症指数(SII)是否对经导管主动脉瓣植入术(TAVI)治疗的主动脉瓣狭窄(AS)患者的主要不良心脏事件(MACEs),包括中风、再住院和 6 个月内短期全因死亡率具有预后价值。我们回顾性纳入了 120 例因严重 AS 而行 TAVI 的患者。本研究的主要终点是 6 个月时的 MACEs 和短期全因死亡率。结果发现,发生 MACEs 的 TAVI 患者的 SII 高于未发生 MACEs 的患者。多变量 Cox 回归分析显示,SII(HR:1.002,95%CI:1.001-1.003, < 0.01)是 TAVI 后 AS 患者发生 MACEs 的独立预测因子。SII 预测 TAVI 后 AS 患者发生 MACEs 的最佳值为>1.056,具有 94%的敏感性和 96%的特异性(AUC(曲线下面积):0.960, < 0.01)。我们注意到,SII 预测 MACEs 的 AUC 值明显高于 C 反应蛋白的 AUC 值(AUC:0.960 与 AUC:0.714)。这是第一项表明高术前 SII 可能对 TAVI 治疗的 AS 患者的 MACEs 和短期死亡率具有预测价值的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a889/8228319/a845ec9d1c80/medicina-57-00588-g001.jpg

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