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可溶性 ST2 水平与肺栓塞 6 个月死亡率和/或心血管相关再住院的关系。

Association of soluble ST2 Level with 6-month Mortality and/or Recurrent Cardiovascular-Related Hospitalization in Pulmonary Embolism.

机构信息

Department of Cardiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras - Turkey.

Department of Physiology, Cumnhuriyet University, Faculty of Medicine, Sivas - Turkey.

出版信息

Arq Bras Cardiol. 2024 Feb 23;121(2):e20230040. doi: 10.36660/abc.20230040. eCollection 2024.

Abstract

BACKGROUND

The association of soluble suppression of tumorigenesis-2 (sST2) levels with prognosis in pulmonary embolism (PE) is unknown.

OBJECTIVE

This study aimed to investigate the relationship between sST2 levels in patients with acute PE and 6-month mortality and recurrent hospitalizations.

METHODS

This prospective study included 100 patients with acute PE. Patients were classified into two groups according to 6-month mortality and the presence of recurrent Cardiovascular-Related hospitalizations. Two groups were compared. A p-value of 0.05 was considered statistically significant.

RESULTS

Soluble ST2 levels were significantly higher in the group with mortality and recurrent hospitalizations. (138.6 ng/mL (56.7-236.8) vs. 38 ng/mL (26.3-75.4); p<0.001) The best cut-off threshold for sST2 levels in the prediction of a composite outcome of 6-month mortality and/or recurrent Cardiovascular-Related hospitalization was found to be >89.9 with a specificity of 90.6% and a sensitivity of 65.2%, according to the receiver operating characteristic curve (area under the curve = 0.798; 95% CI, 0.705-0.891; p <0.0001). After adjusting for confounding factors that were either statistically significant in the univariate analysis or for the variables correlated with the sST2 levels, sST2 level (OR = 1.019, 95% CI: 1.009-1.028, p 0.001) and C-reactive protein (CRP ) (OR = 1.010, 95% CI: 1.001-1.021, p = 0.046) continued to be significant predictors of 6-month mortality and/or recurrent Cardiovascular-Related hospitalization in the multiple logistic regression model via backward stepwise method.

CONCLUSION

Soluble ST2 level seems to be a biomarker to predict 6-month mortality and/or recurrent Cardiovascular-Related hospitalization in patients with acute PE.

摘要

背景

可溶性抑制肿瘤发生-2(sST2)水平与肺栓塞(PE)预后的关系尚不清楚。

目的

本研究旨在探讨急性 PE 患者 sST2 水平与 6 个月死亡率和复发性住院之间的关系。

方法

本前瞻性研究纳入了 100 例急性 PE 患者。根据 6 个月死亡率和复发性心血管相关住院情况,将患者分为两组。对两组进行比较。p 值<0.05 被认为具有统计学意义。

结果

死亡率和复发性住院组可溶性 ST2 水平显著升高。(138.6ng/ml(56.7-236.8)vs.38ng/ml(26.3-75.4);p<0.001)根据受试者工作特征曲线(曲线下面积=0.798;95%CI,0.705-0.891;p<0.0001),sST2 水平预测 6 个月死亡率和/或复发性心血管相关住院的最佳截断值>89.9,特异性为 90.6%,敏感性为 65.2%。在校正单因素分析中有统计学意义的混杂因素或与 sST2 水平相关的变量后,sST2 水平(OR=1.019,95%CI:1.009-1.028,p<0.001)和 C 反应蛋白(CRP)(OR=1.010,95%CI:1.001-1.021,p=0.046)仍然是通过逐步向后法构建的多变量逻辑回归模型中 6 个月死亡率和/或复发性心血管相关住院的显著预测因素。

结论

sST2 水平似乎是预测急性 PE 患者 6 个月死亡率和/或复发性心血管相关住院的生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53b3/11081135/b8ed7616e932/0066-782X-abc-121-02-e20230040-gf01.jpg

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