Witoslawska Angelika, Meessen Jennifer M T A, Hilvo Mika, Jylhä Antti, Zannad Faiez, Cerrato Marianna, Rossignol Patrick, Novelli Deborah, Duarte Kevin, Targher Giovanni, Latini Roberto, Girerd Nicolas, Laaksonen Reijo
Finnish Cardiovascular Research Center, University of Tampere, Tampere, Finland.
Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy.
Eur J Clin Invest. 2025 Mar;55(3):e14359. doi: 10.1111/eci.14359. Epub 2024 Nov 23.
Ceramide and phosphatidylcholine lipids-based risk score (CERT2) has shown a strong prognostic value in predicting cardiovascular (CV) events in patients with ischemic heart disease. This study aimed to investigate the prognostic value of CERT2 risk score in patients with heart failure (HF).
The current study combines data for 4234 subjects from the COMMANDER-HF trial and 1227 subjects from the GISSI-HF trial, which enrolled patients with a history of HF. The CERT2 risk score was calculated for all the participants as previously described. The primary outcome was CV death, but all-cause death and major adverse CV events (three-point MACE) were analysed as well.
After adjustment for established CV risk factors and potential confounders, patients with the highest CERT2 risk category remained at almost three-fold higher risk of CV death (COMMANDER-HF: HR 2.80, 95% CI 2.18-3.60, GISSI-HF: 2.84, 95% CI 1.70-4.74), all-cause death (COMMANDER-HF: HR 2.97, 95% CI 2.36-3.75, GISSI-HF: 2.83, 95% CI 1.83-4.38) and MACE (COMMANDER-HF: HR 2.73, 95% CI 2.20-3.38, GISSI-HF: 2.67, 95% CI 1.67-4.26) compared to those with the lowest CERT2 risk category.
The CERT2 risk score is strongly associated with an increased risk of CV death, all-cause death and MACE in patients with HF.
基于神经酰胺和磷脂酰胆碱的脂质风险评分（CERT2）在预测缺血性心脏病患者的心血管（CV）事件方面显示出很强的预后价值。本研究旨在探讨CERT2风险评分在心力衰竭（HF）患者中的预后价值。
本研究合并了来自COMMANDER-HF试验的4234名受试者和来自GISSI-HF试验的1227名受试者的数据，这两项试验纳入了有HF病史的患者。如前所述，为所有参与者计算CERT2风险评分。主要结局是CV死亡，但也分析了全因死亡和主要不良CV事件（三分制MACE）。
在调整既定的CV风险因素和潜在混杂因素后，与CERT2风险类别最低的患者相比，CERT2风险类别最高的患者发生CV死亡（COMMANDER-HF：HR 2.80，95%CI 2.18-3.60，GISSI-HF：2.84，95%CI 1.70-4.74）、全因死亡（COMMANDER-HF：HR 2.97，95%CI 2.36-3.75，GISSI-HF：2.83，95%CI 1.83-4.38）和MACE（COMMANDER-HF：HR 2.73，95%CI 2.20-3.38，GISSI-HF：2.67，95%CI 1.67-4.26）的风险几乎高出三倍。
CERT2风险评分与HF患者发生CV死亡、全因死亡和MACE的风险增加密切相关。
