Wang Jie, Tang Manyun, Long Yunxiang, Song Jingzhuo, Chen Limei, Wang Mengchang, Li Yongxin, Sun Chaofeng, Yan Yang
Atrial Fibrillation Centre and Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Cardiovasc Med. 2021 Sep 27;8:681484. doi: 10.3389/fcvm.2021.681484. eCollection 2021.
The prognosis of patients with multiple myeloma (MM) is variable and partly depends on their cardiovascular status. The presence of arrhythmias can lead to worse outcomes. Therefore, this study aimed to evaluate the potential of heart rate (HR) and hypertension in predicating the outcomes of MM patients. This study retrospectively enrolled patients with MM between January 1, 2010, and December 31, 2018, at the First Affiliated Hospital of Xi'an Jiaotong University. The endpoint was all-cause mortality. The Pearson's chi-square test was used to assess the association between hypertension and outcomes. Univariate and multivariate Cox proportional hazards models were developed to evaluate the relationship between HR and all-cause mortality. A total of 386 patients were included. The mean HR was 83.8 ± 23.1 beats per minute (bpm). Patients with HR >100 bpm had a higher all-cause mortality (79.4%, 50/63) than those with 60 ≤ HR ≤ 100 bpm (39.9%, 110/276) and <60 bpm (19.1%, 9/47) ( < 0.001). Subgroup analysis based on the International Staging System and sex revealed similar relationships ( < 0.01). When stratified by age, patients with HR >100 bpm had higher all-cause mortality than those with a lower HR when age was <65 years or 65-75 years ( < 0.001) but not >75 years. The proportion of patients with hypertension was 54.7% (211/386). However, hypertension was not associated with all-cause mortality in MM patients (χ=1.729, > 0.05). MM patients with HR >100 bpm had the highest all-cause mortality. The prognostic potential of HR may be useful in aiding risk stratification and promoting the management of these patients.
多发性骨髓瘤(MM)患者的预后各不相同,部分取决于其心血管状况。心律失常的存在可能导致更差的预后。因此,本研究旨在评估心率(HR)和高血压对MM患者预后的预测潜力。本研究回顾性纳入了2010年1月1日至2018年12月31日期间在西安交通大学第一附属医院就诊的MM患者。终点为全因死亡率。采用Pearson卡方检验评估高血压与预后之间的关联。建立单因素和多因素Cox比例风险模型以评估HR与全因死亡率之间的关系。共纳入386例患者。平均心率为83.8±23.1次/分钟(bpm)。心率>100 bpm的患者全因死亡率(79.4%,50/63)高于心率在60≤HR≤100 bpm的患者(39.9%,110/276)和<60 bpm的患者(19.1%,9/47)(<0.001)。基于国际分期系统和性别的亚组分析显示了相似的关系(<0.01)。按年龄分层时,年龄<65岁或65 - 75岁时,心率>100 bpm的患者全因死亡率高于心率较低的患者(<0.001),但年龄>75岁时并非如此。高血压患者的比例为54.7%(211/386)。然而高血压与MM患者的全因死亡率无关(χ=1.729,>0.05)。心率>100 bpm的MM患者全因死亡率最高。HR的预后预测潜力可能有助于风险分层和促进对这些患者的管理。