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JAHA：AHEAD评分预测心衰患者预后性能如何？

2017-05-08 xing.T MedSci原创

AHEAD心衰预后预测
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在亚洲急性心衰队列中，无论是HFrEF还是HFpEF患者，AHEAD评分可以有效地预测患者长期死亡率。新的AHEAD-U评分可以进一步改善风险分层

AHEAD（A：心房颤动；H：血红蛋白；E：老年人；A：异常肾功能参数；D：糖尿病）评分与急性心力衰竭患者的临床结局有关。然而，无论是在左室射血分数正常还是降低的急性心力衰竭（HFrEF和HFpEF）患者中AHEAD评分的预后价值仍不清楚。近日，心血管疾病领域权威杂志JAHA上针对这一问题发表了一篇研究文章。

本研究人群由2143例住院的急性心力衰竭患者组成（77±12岁，68%为男性，38%为HFrEF患者），平均随访了23.75个月。研究人员采用Cox回归分析评估AHEAD评分（房颤、血红蛋白＜13mg/dL男性或12mg/dL女性、年龄>70岁、肌酐＞130μmol/L、糖尿病）预测心血管及全因死亡率的能力。

在总体研究人群中，平均AHEAD得分为2.7±1.2，HFrEF患者中为2.6±1.3，HFpEF患者为2.7±1.1。在对性别、钠水平、尿酸和药物进行调整后，AHEAD得分仍然与全因和心血管死亡显著相关（风险比和95%可信区间分别为：1.49，1.38-1.60和1.48，1.33-1.64）。在HFrEF（1.63，1.47-1.82）和HFpEF（1.34，1.22-1.48）患者亚组中，AHEAD得分与死亡率之间的相关性仍然显著。此外，研究人员将尿酸（>8.6mg/dL）纳入到AHEAD评分中计算得到一个新的AHEAD-U评分，预测全因和心血管疾病死亡的净重分类指标分别改善了19.7%和20.1%。

在亚洲急性心衰队列中，无论是HFrEF还是HFpEF患者，AHEAD评分可以有效地预测患者长期死亡率。新的AHEAD-U评分可以进一步改善风险分层。

原始出处：

Yu‐Jen Chen, et al. Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function.JAHA.2017. https://doi.org/10.1161/JAHA.116.004297

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    2017-11-01 bnurmamat

    #患者预后#

    0

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    2017-11-23 nymo

    #AHEAD#

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    2017-05-10 zhaohui6731

    #AHA#

    0

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    2017-05-10 yuanming7

    #心衰患者#

    0