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尿酸/白蛋白比值:经皮冠状动脉介入治疗后不稳定型心绞痛患者长期心脏死亡率的新预测指标。

The uric acid to albumin ratio: a novel predictor of long-term cardiac mortality in patients with unstable angina pectoris after percutaneous coronary intervention.

机构信息

Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.

Department of Cardiology, Baoding First Central Hospital, Baoding, China.

出版信息

Scand J Clin Lab Invest. 2022 Jul;82(4):304-310. doi: 10.1080/00365513.2022.2084698. Epub 2022 Jun 8.

DOI:10.1080/00365513.2022.2084698
PMID:35675042
Abstract

The prognosis of unstable angina pectoris (UAP) differs from non-ST-segment elevation myocardial infarction, and percutaneous coronary intervention (PCI) is considered to improve outcomes of UAP. This study aimed to assess the prognostic value of uric acid to albumin ratio (UAR) for long-term mortality in UAP patients after PCI. Our study retrospectively enrolled 2298 patients hospitalized because of UAP in a tertiary hospital. Divided by medium UAR, the patients were classified into two groups. Baseline demographics, clinical features and laboratory characteristics were obtained from medical records. Post-discharge follow-up was performed either in outdoor clinic or through phone call. The primary endpoint in this study was cardiac death, while all-cause death and rehospitalization were designated as the secondary endpoints. The median follow-up time was 672 days. Among all patients, 58 (2.5%) died, 28 of which died of cardiac deaths (1.2%), and 467 were re-hospitalized (20.3%). Cardiac mortality and all-cause mortality were found to be significantly higher in the high UAR group than in the low UAR group ( = 0.007,  < 0.001), and Kaplan-Meier analysis showed patients with higher UAR may suffer from worse outcomes ( = 0.020). UAR, PCI history, and age were identified as independent predictors of cardiac mortality by multivariate Cox regression. A UAR value of >8.35 was demonstrated as an ideal cut-off point to predict post-PCI cardiac mortality ( <0.001). Overall, it is indicated that baseline UAR was independently correlated with long-term cardiac mortality in patients with UAP treated by PCI.

摘要

不稳定型心绞痛(UAP)的预后与非 ST 段抬高型心肌梗死不同,经皮冠状动脉介入治疗(PCI)被认为可改善 UAP 的预后。本研究旨在评估尿酸与白蛋白比值(UAR)对 PCI 后 UAP 患者长期死亡率的预测价值。

我们的研究回顾性纳入了一家三级医院因 UAP 住院的 2298 例患者。根据 UAR 的中位数将患者分为两组。从病历中获取患者的基线人口统计学、临床特征和实验室特征。通过门诊或电话进行出院后随访。本研究的主要终点是心脏性死亡,全因死亡和再住院被指定为次要终点。

中位随访时间为 672 天。所有患者中,有 58 例(2.5%)死亡,其中 28 例死于心脏性死亡(1.2%),467 例再住院(20.3%)。高 UAR 组的心脏死亡率和全因死亡率均明显高于低 UAR 组(=0.007,<0.001),Kaplan-Meier 分析显示 UAR 较高的患者预后较差(=0.020)。多变量 Cox 回归分析显示,UAR、PCI 史和年龄是心脏死亡率的独立预测因素。UAR 值>8.35 被证明是预测 PCI 后心脏死亡率的理想截断点(<0.001)。

总之,基线 UAR 与 PCI 治疗的 UAP 患者的长期心脏死亡率独立相关。

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