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血红蛋白与血清铁水平和冠心病患者死亡风险之间的关联

Associations Between Hemoglobin and Serum Iron Levels and the Risk of Mortality Among Patients with Coronary Artery Disease.

作者信息

Li Qing, Pan Zhijun, Zeng Yupeng, Wang Xu, Li Dan, Yin Ting, Chen Qian, Ling Wenhua

机构信息

School of Public Health, Sun Yat-sen University, 74, Zhongshan Rd. 2, Guangzhou 510080, China.

Department of Clinical Nutrition, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106, Zhongshan Rd. 2, Guangzhou 510080, China.

出版信息

Nutrients. 2024 Dec 31;17(1):139. doi: 10.3390/nu17010139.

Abstract

BACKGROUND

This study aimed to investigate the relationship between hemoglobin and serum iron levels and mortality risk in patients with coronary artery disease (CAD).

METHODS

We analyzed data from 3224 patients with CAD using Cox proportional hazards regression models to assess the association of hemoglobin and serum iron levels with cardiovascular and all-cause mortality from the Guangdong coronary artery disease cohort.

RESULTS

Over a median follow-up period of 8.9 years, 636 patients died, including 403 from cardiovascular causes. Higher hemoglobin and serum iron levels were linked to a reduced risk of cardiovascular and all-cause mortality. Patients in the highest quartiles of hemoglobin and serum iron levels had multivariable-adjusted hazard ratios (HRs) of 0.62 (95% CI, 0.46-0.85) and 0.51 (95% CI, 0.37-0.69) for cardiovascular mortality and 0.64 (95% CI, 0.50-0.83) and 0.67 (95% CI, 0.53-0.85) for all-cause mortality, compared with those in the lowest quartile. A one-standard-deviation increase in hemoglobin and serum iron levels corresponded to a 19% and 24% reduction in cardiovascular mortality risk and a 19% reduction in all-cause mortality risk for both factors. Restricted cubic spline analysis revealed L-shaped and U-shaped associations between hemoglobin and serum iron levels and cardiovascular and all-cause mortality, respectively.

CONCLUSIONS

Hemoglobin and serum iron levels were significantly associated with lower risks of cardiovascular and all-cause mortality in patients with CAD. Further research is needed to evaluate the effects of iron supplementation in these patients.

摘要

背景

本研究旨在探讨血红蛋白和血清铁水平与冠心病(CAD)患者死亡风险之间的关系。

方法

我们使用Cox比例风险回归模型分析了来自广东冠心病队列的3224例CAD患者的数据,以评估血红蛋白和血清铁水平与心血管及全因死亡率的关联。

结果

在中位随访期8.9年期间,636例患者死亡,其中403例死于心血管原因。较高的血红蛋白和血清铁水平与心血管及全因死亡率降低相关。血红蛋白和血清铁水平处于最高四分位数的患者,与最低四分位数的患者相比,心血管死亡率的多变量调整风险比(HR)为0.62(95%CI,0.46 - 0.85)和0.51(95%CI,0.37 - 0.69),全因死亡率的HR为0.64(95%CI,0.50 - 0.83)和0.67(95%CI,0.53 - 0.85)。血红蛋白和血清铁水平每增加一个标准差,心血管死亡率风险分别降低19%和24%,两种因素导致的全因死亡率风险均降低19%。限制立方样条分析显示,血红蛋白和血清铁水平与心血管及全因死亡率之间分别呈L形和U形关联。

结论

血红蛋白和血清铁水平与CAD患者较低的心血管及全因死亡风险显著相关。需要进一步研究评估这些患者补充铁剂的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e38/11722639/5d4db3d146f8/nutrients-17-00139-g001.jpg

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