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白蛋白与纤维蛋白原比值对肥厚型心肌病患者死亡率的预测价值。

Prognostic value of albumin to fibrinogen ratio for mortality in patients with hypertrophic cardiomyopathy.

机构信息

Department of Cardiology, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, China.

Department of Equipment, Sichuan University West China Hospital, Chengdu, China.

出版信息

BMC Cardiovasc Disord. 2023 Nov 16;23(1):559. doi: 10.1186/s12872-023-03562-8.

Abstract

BACKGROUND

Albumin to fibrinogen ratio (AFR), a new inflammatory marker, has emerged as a useful indicator to predict adverse outcomes for several diseases. However, whether AFR could be a new useful indicator to predict mortality in HCM patients remains to be evaluated. The study explored the predictive value of AFR for HCM-related death in adult HCM patients.

METHODS

A total of 404 HCM patients were eventually enrolled in the study according to the inclusion criteria. Patients were divided into two groups based on the median of baseline AFR. The association between AFR and HCM-related death was analyzed.

RESULTS

During a median follow-up of 4.75 years, HCM-related death was observed in 45 patients (11.1%). The incidence of HCM-related death was significantly higher in the low AFR group (log-rank p < 0.001). With the high AFR group as reference, the unadjusted hazard ratio (HR) for HCM-related death was 2.97 (95% confidence interval [CI]: 1.53-5.75, p = 0.001) in the low AFR group, and after adjusting for potentially confounding variables, the adjusted HR for low AFR group was 3.15 (95% CI: 1.56-6.37, p = 0.001). No significant interactions between AFR and other variables were observed in subgroup analysis. Sensitivity analyses in patients with normal albumin and fibrinogen showed similar results.

CONCLUSION

AFR is an independent prognostic factor for HCM-related death, adult HCM patients with a lower AFR have a higher risk of HCM-related death.

摘要

背景

白蛋白与纤维蛋白原比值(AFR)是一种新的炎症标志物,已被证明是预测多种疾病不良结局的有用指标。然而,AFR 是否可以成为预测 HCM 患者死亡率的新有用指标仍有待评估。本研究探讨了 AFR 对成年 HCM 患者与 HCM 相关死亡的预测价值。

方法

根据纳入标准,最终共有 404 名 HCM 患者纳入本研究。根据基线 AFR 的中位数将患者分为两组。分析 AFR 与 HCM 相关死亡之间的关系。

结果

在中位随访 4.75 年后,45 名患者(11.1%)发生与 HCM 相关的死亡。低 AFR 组的 HCM 相关死亡率显著较高(对数秩检验 p<0.001)。以高 AFR 组为参照,低 AFR 组发生与 HCM 相关的死亡的未调整风险比(HR)为 2.97(95%置信区间 [CI]:1.53-5.75,p=0.001),在校正潜在混杂变量后,低 AFR 组的调整 HR 为 3.15(95%CI:1.56-6.37,p=0.001)。亚组分析中未观察到 AFR 与其他变量之间存在显著交互作用。在白蛋白和纤维蛋白原正常的患者中进行敏感性分析,结果相似。

结论

AFR 是与 HCM 相关死亡的独立预后因素,AFR 较低的成年 HCM 患者发生与 HCM 相关死亡的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7189/10652625/513c89d86327/12872_2023_3562_Fig1_HTML.jpg

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