Yuan Xiaoye, Lv Caixia, Wu Sisi, Wang Huiying, Liu Xiaoyu
Department of Geriatric Cardiovascular, Hebei General Hospital, Shijiazhuang, 050000, People's Republic of China.
Int J Gen Med. 2024 Mar 6;17:863-870. doi: 10.2147/IJGM.S453538. eCollection 2024.
To investigate the predictive value of hemoglobin (Hb) to red blood cell distribution width (RDW) (Hb/RDW) ratio in combination with serum sodium for major adverse cardiovascular events (MACE) in elderly acute heart failure patients with preserved ejection fraction at 30 days after discharge.
130 elderly acute heart failure patients with preserved ejection fraction were enrolled and followed up at 30 days after discharge. They were classified into the MACE group (n=11) and none-MACE group (n=119). On the day of admission, clinical baseline characteristics were measured and results from laboratory tests were gathered. The correlation and predictive value of Hb/RDW and serum sodium with the occurrence of MACE at 30 days after discharge in acute heart failure patients with preserved ejection fraction in the elderly were analyzed.
Spearman correlation analysis showed that the occurrence of MACE was negatively correlated with Hb/RDW, serum sodium (r=-0.209, r=0.291, p<0.05) and Hb/RDW (OR=0.484, 95% CI:0.254, 0.922), serum sodium (OR=0.779, 95% CI:0.646,0.939) were independent risk factors (p<0.05) analyzed by multifactorial logistic. Receiver operating characteristic curves (ROC) analysis showed that the area under the curve (AUC) for the prediction of MACE by Hb/RDW was 0.73, with an optimal threshold of 9.28, sensitivity 81.80%, specificity 70.60%, positive predictive value (PPV) 20.50%, negative predictive value (NPV) 97.70%; the AUC of serum sodium for predicting the occurrence of MACE was 0.76, with an optimal threshold of 140.35 mmol/L, sensitivity 90.90%, specificity 57.10%, PPV 16.40%, NPV 98.60%; and the AUC of Hb/RDW combined serum sodium to predict the occurrence of MACE was 0.83, with sensitivity 90.90%, specificity 78.20%, PPV 27.80% and NPV 98.90%.
Hb/RDW and serum sodium had negative correlation with MACE and were independent risk factors of 30-day MACE; Hb/RDW combined with serum sodium can predict 30-day MACE occurrence in elderly acute heart failure patients with preserved ejection fraction.
探讨血红蛋白（Hb）与红细胞分布宽度（RDW）比值（Hb/RDW）联合血清钠对老年射血分数保留的急性心力衰竭患者出院后30天主要不良心血管事件（MACE）的预测价值。
纳入130例老年射血分数保留的急性心力衰竭患者，出院后30天进行随访。将其分为MACE组（n = 11）和非MACE组（n = 119）。入院当天测量临床基线特征并收集实验室检查结果。分析老年射血分数保留的急性心力衰竭患者出院后30天Hb/RDW和血清钠与MACE发生的相关性及预测价值。
Spearman相关性分析显示，MACE的发生与Hb/RDW、血清钠呈负相关（r = -0.209，r = 0.291，p < 0.05）；多因素logistic分析显示，Hb/RDW（OR = 0.484，95%CI：0.254，0.922）、血清钠（OR = 0.779，95%CI：0.646，0.939）是独立危险因素（p < 0.05）。受试者工作特征曲线（ROC）分析显示，Hb/RDW预测MACE的曲线下面积（AUC）为0.73，最佳阈值为9.28，灵敏度81.80%，特异度70.60%，阳性预测值（PPV）20.50%，阴性预测值（NPV）97.70%；血清钠预测MACE发生的AUC为0.76，最佳阈值为140.35 mmol/L，灵敏度90.90%，特异度57.10%，PPV 16.40%，NPV 98.60%；Hb/RDW联合血清钠预测MACE发生的AUC为0.83，灵敏度90.90%，特异度78.20%，PPV 27.80%，NPV 98.90%。
Hb/RDW和血清钠与MACE呈负相关，是30天MACE的独立危险因素；Hb/RDW联合血清钠可预测老年射血分数保留的急性心力衰竭患者30天MACE的发生。
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