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血清钙化倾向与外周动脉疾病的心血管结局。

Calcification Propensity in Serum and Cardiovascular Outcome in Peripheral Artery Disease.

机构信息

Division of Nephrology, Medicine III, Medical University of Vienna, Austria.

Department of Medicine III, Nephrology, Transplantation Medicine, Rheumatology, Geriatrics, Ordensklinikum Linz Elisabethinen, Linz, Austria.

出版信息

Thromb Haemost. 2022 Jun;122(6):1040-1046. doi: 10.1055/s-0041-1736444. Epub 2021 Oct 31.

Abstract

Peripheral artery disease (PAD) has been shown to be linked to elevated cardiovascular risk. The novel T test quantifies calcification propensity of serum and has been associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD) and in the general population. This study investigated the association of calcification propensity measured by the T test in 287 patients with PAD without severe CKD. Major cardiovascular events (MACEs) including nonfatal stroke and nonfatal myocardial infarction and all-cause death (MACE + ) were evaluated after a median follow-up of 4 years and long-term cardiovascular and all-cause mortality after a median follow-up of 8.7 years by Kaplan-Meier and Cox regression analyses. Mean T time was 268 ± 63 minutes in the study cohort (age 69 ± 10 years, 32% women, 47% diabetes). Low T values that signify high calcification propensity were significantly associated with the occurrence of MACE+ (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.55-0.94). This association sustained multivariate adjustment for cardiovascular risk factors (CVRFs), Fontaine PAD stage, and prevalent media sclerosis (HR: 0.65; CI: 0.47-0.91). Cardiovascular mortality was significantly associated with T after multivariate adjustment for CVRF (HR: 0.72; CI 0.53-0.99), but not all-cause mortality (HR: 0.80; CI: 0.64-1.01). In conclusion, calcification propensity associates with MACE+ and cardiovascular mortality in patients with PAD.

摘要

外周动脉疾病 (PAD) 与心血管风险升高有关。新型 T 检验定量检测血清钙化倾向,与慢性肾脏病 (CKD) 患者和普通人群中的心血管事件和死亡率相关。本研究调查了 287 例无严重 CKD 的 PAD 患者 T 检验测量的钙化倾向与主要心血管事件 (MACE) 的相关性,MACE 包括非致死性中风和非致死性心肌梗死以及全因死亡 (MACE + )。中位随访 4 年后,通过 Kaplan-Meier 和 Cox 回归分析评估 MACE + 的发生,中位随访 8.7 年后评估长期心血管和全因死亡率。研究队列的平均 T 时间为 268 ± 63 分钟(年龄 69 ± 10 岁,32%为女性,47%患有糖尿病)。表示高钙化倾向的低 T 值与 MACE + 的发生显著相关(风险比[HR]:0.72;95%置信区间[CI]:0.55-0.94)。这种关联在多变量调整心血管危险因素 (CVRF)、Fontaine PAD 分期和普遍存在的媒体硬化后仍然存在(HR:0.65;CI:0.47-0.91)。多变量调整 CVRF 后,心血管死亡率与 T 显著相关(HR:0.72;CI 0.53-0.99),但与全因死亡率无关(HR:0.80;CI:0.64-1.01)。总之,钙化倾向与 PAD 患者的 MACE + 和心血管死亡率相关。

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