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高敏 C 反应蛋白/白蛋白比值与经皮冠状动脉介入治疗患者心血管预后的关系。

The Association Between High-Sensitivity C-Reactive Protein/Albumin Ratio and Cardiovascular Prognosis in Patients Undergoing Percutaneous Coronary Intervention.

机构信息

Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, 34736Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Cardiology and Institute of Vascular Medicine, 66482Peking University Third Hospital; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China.

出版信息

Angiology. 2022 Oct;73(9):818-826. doi: 10.1177/00033197221110715. Epub 2022 Jun 24.

Abstract

Limited studies have focused on the impact of high-sensitivity C-reactive protein (hsCRP) to albumin ratio (CAR) on cardiovascular outcomes in patients undergoing percutaneous coronary intervention (PCI). Hence, the present study evaluates the association between CAR and cardiovascular outcomes in patients undergoing drug-eluting stent (DES) implantation. We consecutively enrolled 9375 CHD patients undergoing DES implantation. All patients were divided into 3 groups according to their CAR: tertile 1 (CAR ≤.02, n=3125), tertile 2 (.02<CAR≤.06, n = 3125), and tertile 3 (CAR >.06, n = 3125). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Kaplan-Meier analysis indicated that the incidences of MACCE and MI increased with high tertiles of the CAR (MACCE: 8.7 vs 10.5 vs 12.3%, log-rank P < .001; MI: 3.3 vs 4.0 vs 4.7%, long-rank P = .015). Cox regression analysis suggested that CAR was an independent risk factors for MACCE (HR per standard deviation (SD) increase: 1.07, 95% CI, 1.01-1.14, P = .024), and MI (HR per SD increase: 1.11, 95% CI, 1.01-1.22, P = .028). In conclusion the CAR is an independent predictor of MACCE and MI in CHD patients.

摘要

目前,仅有少数研究关注高敏 C 反应蛋白(hsCRP)与白蛋白比值(CAR)对行经皮冠状动脉介入治疗(PCI)患者心血管结局的影响。因此,本研究旨在评估 CAR 与行经药物洗脱支架(DES)植入术的冠心病(CHD)患者心血管结局之间的相关性。我们连续纳入 9375 例行 DES 植入术的 CHD 患者。所有患者根据 CAR 分为 3 组:三分位 1 组(CAR≤.02,n=3125)、三分位 2 组(.02<CAR≤.06,n=3125)和三分位 3 组(CAR>.06,n=3125)。主要终点是主要不良心血管和脑血管事件(MACCE)。Kaplan-Meier 分析表明,随着 CAR 三分位的升高,MACCE 和心肌梗死(MI)的发生率也随之增加(MACCE:8.7%比 10.5%比 12.3%,对数秩检验 P<0.001;MI:3.3%比 4.0%比 4.7%,对数秩检验 P=0.015)。Cox 回归分析表明,CAR 是 MACCE 的独立危险因素(每标准差增加的 HR:1.07,95%CI:1.01-1.14,P=0.024)和 MI(每标准差增加的 HR:1.11,95%CI:1.01-1.22,P=0.028)。综上所述,CAR 是 CHD 患者 MACCE 和 MI 的独立预测因子。

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