Department of Cardiovascular Medicine, Zibo Central Hospital, No.54 Communist Youth League West Road, Zhangdian District, Zibo, 255036, P.R. China.
Department of Intensive Care Medicine, Zibo Central Hospital, Zibo, 255036, P.R. China.
BMC Cardiovasc Disord. 2024 Aug 24;24(1):447. doi: 10.1186/s12872-024-04112-6.
Alactic base excess (ABE) is a novel biomarker to evaluate the renal capability of handling acid-base disturbances, which has been found to be associated with adverse prognosis of sepsis and shock patients. This study aimed to evaluate the association between ABE and the risk of in-hospital mortality in patients with acute myocardial infarction (AMI).
This retrospective cohort study collected AMI patients' clinical data from the Medical Information Mart for Intensive Care (MIMIC)-IV database. The outcome was in-hospital mortality after intensive care unit (ICU) admission. Univariate and multivariate Cox proportional hazards models were performed to assess the association of ABE with in-hospital mortality in AMI patients, with hazard ratios (HRs) and 95% confidence intervals (CI). To further explore the association, subgroup analyses were performed based on age, AKI, eGFR, sepsis, and AMI subtypes.
Of the total 2779 AMI patients, 502 died in hospital. Negative ABE (HR = 1.26, 95%CI: 1.02-1.56) (neutral ABE as reference) was associated with a higher risk of in-hospital mortality in AMI patients, but not in positive ABE (P = 0.378). Subgroup analyses showed that negative ABE was significantly associated with a higher risk of in-hospital mortality in AMI patients aged>65 years (HR = 1.46, 95%CI: 1.13-1.89), with eGFR<60 (HR = 1.35, 95%CI: 1.05-1.74), with AKI (HR = 1.32, 95%CI: 1.06-1.64), with ST-segment elevation acute myocardial infarction (STEMI) subtype (HR = 1.79, 95%CI: 1.18-2.72), and without sepsis (HR = 1.29, 95%CI: 1.01-1.64).
Negative ABE was significantly associated with in-hospital mortality in patients with AMI.
无乳酸性碱剩余（ABE）是一种新型生物标志物，用于评估肾脏处理酸碱失衡的能力，已发现其与脓毒症和休克患者的不良预后相关。本研究旨在评估 ABE 与急性心肌梗死（AMI）患者住院期间死亡率的关系。
本回顾性队列研究从医疗信息监测与解析数据库（MIMIC-IV 数据库）中收集 AMI 患者的临床数据。研究结局为入住重症监护病房（ICU）后住院期间的死亡率。采用单因素和多因素 Cox 比例风险模型评估 ABE 与 AMI 患者住院期间死亡率的关系，计算风险比（HR）和 95%置信区间（CI）。为了进一步探讨这种关系，根据年龄、急性肾损伤（AKI）、估算肾小球滤过率（eGFR）、脓毒症和 AMI 亚型进行了亚组分析。
在 2779 名 AMI 患者中，有 502 人在住院期间死亡。与中性 ABE（作为参考）相比，负 ABE（HR=1.26，95%CI：1.02-1.56）与 AMI 患者住院期间死亡率升高相关，但正 ABE 无此相关性（P=0.378）。亚组分析显示，在年龄>65 岁（HR=1.46，95%CI：1.13-1.89）、eGFR<60（HR=1.35，95%CI：1.05-1.74）、AKI（HR=1.32，95%CI：1.06-1.64）、ST 段抬高型急性心肌梗死（STEMI）亚型（HR=1.79，95%CI：1.18-2.72）和无脓毒症（HR=1.29，95%CI：1.01-1.64）的 AMI 患者中，负 ABE 与住院期间死亡率显著相关。
负 ABE 与 AMI 患者住院期间死亡率显著相关。
