血清人附睾蛋白4水平与急性心力衰竭合并慢性肾脏病患者的不良预后相关。

HE4 Serum Levels are Associated with Poor Prognosis in Patients with Acute Heart Failure Combined with Chronic Kidney Disease.

作者信息

Tang Yi, Hu Zhengqi, Liu Zhibin, Peng Siling, Liu Tiancheng, Xiao Yaoyuan, Peng Jianqiang, Pan Hongwei, Zheng Zhaofen, He Jin

机构信息

Department of Cardiology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Clinical Medicine Research Center of Heart Failure of Hunan Province, Hunan Normal University, Changsha, People's Republic of China.

Department of Cardiology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha, People's Republic of China.

出版信息

Int J Gen Med. 2024 Apr 2;17:1273-1280. doi: 10.2147/IJGM.S444680. eCollection 2024.

DOI:10.2147/IJGM.S444680

PMID:38590999

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10999502/

Abstract

PURPOSE

The levels of human epididymis protein 4 (HE4) is associated not only with the prognosis of patients with acute heart failure (AHF), but also with chronic kidney disease (CKD). Our study aims to understand the prediction value of HE4 on prognosis in patients with AHF combined with CKD.

PATIENTS AND METHODS

This study prospectively enrolled patients diagnosed with AHF combined with CKD at the Department of Cardiology of Hunan Provincial People's Hospital from March 2019 to December 2022. Serum levels of HE4 were measured using a chemiluminescence microparticle immunoassay. The endpoint events included heart failure readmission and cardiovascular death.

RESULTS

A total of 130 patients with AHF combined with CKD were included in the stud. The median age is 73 years (interquartile range: 65-79 years). Among the patients, 94 experienced the endpoint events. The multivariable Cox analysis reveals that LnHE4 (HR=2.280, 95% CI 1.300-3.998, = 0.004) and age (HR=1.024, 95% CI 1.003-1.045, = 0.025) are independent predictors of the endpoint events. The Kaplan-Meier survival curve demonstrates that patients with HE4 levels>276.15 pmol/L has a significantly higher incidence of endpoint events compared to those with HE4 levels≤276.15 pmol/L (Log rank test: χ2=19.689, < 0.001). After adjusting for age and gender, the HR is 2.520 (95% CI: 1.626-3.906, < 0.001).

CONCLUSION

HE4 is an independent predictor of heart failure readmission and cardiovascular death in patients with AHF combined with CKD.

摘要

目的

人附睾蛋白4（HE4）水平不仅与急性心力衰竭（AHF）患者的预后相关，还与慢性肾脏病（CKD）有关。我们的研究旨在了解HE4对AHF合并CKD患者预后的预测价值。

患者与方法

本研究前瞻性纳入了2019年3月至2022年12月在湖南省人民医院心内科诊断为AHF合并CKD的患者。采用化学发光微粒子免疫分析法测定血清HE4水平。终点事件包括心力衰竭再入院和心血管死亡。

结果

本研究共纳入130例AHF合并CKD患者。中位年龄为73岁（四分位间距：65 - 79岁）。其中94例患者发生了终点事件。多变量Cox分析显示，LnHE4（风险比[HR]=2.280，95%置信区间[CI] 1.300 - 3.998，P = 0.004）和年龄（HR=1.024，95% CI 1.003 - 1.045，P = 0.025）是终点事件的独立预测因素。Kaplan-Meier生存曲线表明，与HE4水平≤276.15 pmol/L的患者相比，HE4水平>276.15 pmol/L的患者终点事件发生率显著更高（对数秩检验：χ2 = 19.689，P < 0.001）。在调整年龄和性别后，HR为2.520（95% CI：1.626 - 3.906，P < 0.001）。