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急性呼吸困难患者(伴或不伴充血性心力衰竭)中内皮抑素与死亡率的关系:一项单中心、前瞻性、观察性研究。

Association between endostatin and mortality in patients with acute dyspnoea, with or without congestive heart failure: a single-centre, prospective, observational study.

作者信息

Yaghoubi Alexander, Heijl Caroline, Khoshnood Ardavan M, Wändell Per Erik, Carlsson Axel C, Wessman Torgny

机构信息

Emergency Department, Skåne University Hospital, Malmo, Skåne, Sweden.

Department of Cardiology, Skåne University Hospital, Malmö, Skåne, Sweden.

出版信息

BMJ Open. 2025 Jan 11;15(1):e085238. doi: 10.1136/bmjopen-2024-085238.

Abstract

OBJECTIVE

The aim of this study was to assess associations between endostatin levels and short-term mortality in unsorted acute hospitalised dyspnoea patients with or without congestive heart failure (CHF), adjusted for common cardiovascular risk factors.

DESIGN, SETTING AND PARTICIPANTS: In this prospective observational study, 723 hospitalised patients who visited the emergency department at Skåne University Hospital, Sweden, between 2013 and 2018 were included. Of these, 276 had a history of CHF. The association between endostatin levels and 1 month and 3-month mortality was evaluated, stratified by whether patients had a history of CHF or not.

RESULTS

Patients with prior CHF had higher endostatin levels, higher short-term mortality and were more likely to have CHF as discharge diagnosis. In a fully adjusted model, endostatin was independently associated with 3-month mortality (HR=1.01 per 1 ng/mL increment of endostatin; 95% CI 1.00 to 1.02; p=0.016). No evidence of association was identified with 1-month mortality.

CONCLUSIONS

Endostatins are potential biomarkers for 3 months' mortality in patients hospitalised with CHF seeking emergency care with acute dyspnoea. Further studies are needed in different settings to assess the predictive value of endostatins in patients with CHF.

摘要

目的

本研究旨在评估未经分类的急性住院呼吸困难患者(无论有无充血性心力衰竭(CHF))的内皮抑素水平与短期死亡率之间的关联,并对常见心血管危险因素进行校正。

设计、设置和参与者:在这项前瞻性观察性研究中,纳入了2013年至2018年间在瑞典斯科讷大学医院急诊科就诊的723名住院患者。其中,276名有CHF病史。根据患者是否有CHF病史进行分层,评估内皮抑素水平与1个月和3个月死亡率之间的关联。

结果

既往有CHF的患者内皮抑素水平更高,短期死亡率更高,且出院诊断更有可能为CHF。在一个完全校正的模型中,内皮抑素与3个月死亡率独立相关(内皮抑素每增加1 ng/mL,HR = 1.01;95% CI 1.00至1.02;p = 0.016)。未发现与1个月死亡率相关的证据。

结论

内皮抑素是因急性呼吸困难寻求急诊治疗的CHF住院患者3个月死亡率的潜在生物标志物。需要在不同环境中进行进一步研究,以评估内皮抑素在CHF患者中的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8793/11752042/77c72ea2bdad/bmjopen-15-1-g001.jpg

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