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炎症负荷指数与冠心病患者预后的相关性:一项回顾性研究。

Association between inflammatory burden index and prognosis in patients with coronary heart disease: A retrospective study.

作者信息

Lu Wen, Liao Xiaoqin, Jiang Yan, Luo Baolin, Chen Liangwan, Lin Yanjuan

机构信息

School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.

Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.

出版信息

PLoS One. 2025 Jul 7;20(7):e0325287. doi: 10.1371/journal.pone.0325287. eCollection 2025.

Abstract

BACKGROUND

Increasing evidences indicate that systemic inflammation plays a significant role of adverse prognosis in patients with coronary heart disease (CHD). The inflammatory burden index (IBI) is a novel biomarker that reflects systemic inflammation. The aim of this study was to investigate the association between IBI and prognosis of CHD patients.

METHODS

In this retrospective analysis, data from 2453 CHD patients enrolled from December 2017 to December 2022.IBI was defined as neutrophil/lymphocyte*C-reactive protein, with patients categorized into four groups based on quartiles of baseline IBI levels. The primary outcome was adverse cardiovascular and cerebrovascular events (MACCEs) occurring during hospitalization, which included repeat revascularization, new-onset atrial fibrillation (NOAF), stroke, and all-cause in-hospital mortality. Multivariate logistic regression models and restricted cubic spline (RCS) analysis were used to investigate the association between IBI and prognosis of CHD patients.

RESULTS

High levels of IBI were associated with higher risk of MACCEs, especially when IBI ≥ 45.68, patients exhibited a higher risk of MACCEs (P < 0.05). After adjusting for baseline confounders, multivariate logistic regression analysis demonstrated that baseline IBI was an independent predictor for NOAF (Odds Ratio (OR): 2.05; 95% confidence interval (CI): 1.30-3.24; P = 0.002) and contrast-induced nephropathy (CIN) (OR: 1.95; 95%CI: 1.16-3.28; P = 0.012) in CHD patients, mainly driven by the highest quartile. In addition, RCS confirmed a linear relationship between IBI and NOAF (P for non-linear = 0.425) and a nonlinear relationship with CIN (P for non-linear = 0.032).

CONCLUSION

IBI is a promising biomarker of systemic inflammation in CHD patients, where higher IBI levels are associated with adverse prognosis. These findings may aid clinicians in precise decision-making to improve outcomes in patients with CHD.

摘要

背景

越来越多的证据表明,全身炎症在冠心病(CHD)患者的不良预后中起重要作用。炎症负担指数(IBI)是一种反映全身炎症的新型生物标志物。本研究旨在探讨IBI与CHD患者预后之间的关联。

方法

在这项回顾性分析中,收集了2017年12月至2022年12月期间纳入的2453例CHD患者的数据。IBI定义为中性粒细胞/淋巴细胞*C反应蛋白,根据基线IBI水平的四分位数将患者分为四组。主要结局是住院期间发生的不良心脑血管事件(MACCEs),包括再次血管重建、新发房颤(NOAF)、中风和全因住院死亡率。采用多因素logistic回归模型和限制性立方样条(RCS)分析来研究IBI与CHD患者预后之间的关联。

结果

高水平的IBI与MACCEs风险较高相关,尤其是当IBI≥45.68时,患者发生MACCEs的风险更高(P<0.05)。在调整基线混杂因素后,多因素logistic回归分析表明,基线IBI是CHD患者发生NOAF(比值比(OR):2.05;95%置信区间(CI):1.30-3.24;P=0.002)和造影剂肾病(CIN)(OR:1.95;95%CI:1.16-3.28;P=0.012)的独立预测因素,主要由最高四分位数驱动。此外,RCS证实IBI与NOAF之间存在线性关系(非线性P=0.425),与CIN之间存在非线性关系(非线性P=0.032)。

结论

IBI是CHD患者全身炎症的一个有前景的生物标志物,较高的IBI水平与不良预后相关。这些发现可能有助于临床医生进行精确决策,以改善CHD患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99c9/12233253/e23b2a78ac65/pone.0325287.g001.jpg

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