Int J Cardiol:急性心肌梗死患者出院后短期随访B型利钠肽水平的预后价值

2019-01-09 xing.T MedSci原创

由此可见,出院后短期随访BNP水平是AMI患者全因死亡和MACE的有力预后指标。短期随访BNP水平与基础BNP水平的组合是全因死亡率更好的预测因子。

因急性心肌梗死(AMI)住院患者升高的B型利钠肽(BNP)水平与心力衰竭和死亡率相关。但是,出院后BNP的作用尚不清楚。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员旨在评估短期随访的BNP水平与临床结具之间的关系,包括出院后AMI患者的全因死亡率和主要不良血管事件(MACE)。

研究人员通过前瞻性单中心经皮冠状动脉介入治疗(PCI)登记中心,2157例急性心肌梗死患者中共有442例患者在出院后2个月内测量了基础和随访的BNP水平,并进行了回顾性研究。根据随访对数转换的BNP中值,将患者分为4组(低-低、高-低、低-高和高-高)。

中位随访时间为441天(四分位距[IQR]为362-861天)。Logistic回归分析显示短期随访BNP水平是全因死亡的显著预测因子(比值比[OR]为2.265; 95%置信区间[CI]为1.455-3.527)和MACE(在调整协变量后,OR为1.43; 95%CI为1.101-1.858)。基础BNP水平并未预测全因死亡率和MACE。具有较高基础和较高随访BNP水平的个体与全因死亡率显著相关(OR为3.465; 95%CI为1.122-10.700)。

由此可见,出院后短期随访BNP水平是AMI患者全因死亡和MACE的有力预后指标。短期随访BNP水平与基础BNP水平的组合是全因死亡率更好的预测因子。

原始出处:

Jun-WonLee,et al.Prognostic value of short-term follow-up B-type natriuretic peptide levels after hospital discharge in patients with acute myocardial infarction.International Journal of Cardiology.2018.https://doi.org/10.1016/j.ijcard.2019.01.026

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1800927, encodeId=59a5180092eeb, content=<a href='/topic/show?id=21f8e3220f4' target=_blank style='color:#2F92EE;'>#短期随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73220, encryptionId=21f8e3220f4, topicName=短期随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Mon Jan 14 01:40:00 CST 2019, time=2019-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777186, encodeId=76d71e77186f5, content=<a href='/topic/show?id=824d381e70' target=_blank style='color:#2F92EE;'>#B型利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3817, encryptionId=824d381e70, topicName=B型利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=428c39117525, createdName=839640791, createdTime=Sun Dec 15 10:40:00 CST 2019, time=2019-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781994, encodeId=2e641e81994ea, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Sep 05 22:40:00 CST 2019, time=2019-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366478, encodeId=7f8613664e875, content=<a href='/topic/show?id=76923233335' target=_blank style='color:#2F92EE;'>#利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32333, encryptionId=76923233335, topicName=利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac1c235, createdName=tonychen21, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385220, encodeId=d574138522068, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1800927, encodeId=59a5180092eeb, content=<a href='/topic/show?id=21f8e3220f4' target=_blank style='color:#2F92EE;'>#短期随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73220, encryptionId=21f8e3220f4, topicName=短期随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Mon Jan 14 01:40:00 CST 2019, time=2019-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777186, encodeId=76d71e77186f5, content=<a href='/topic/show?id=824d381e70' target=_blank style='color:#2F92EE;'>#B型利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3817, encryptionId=824d381e70, topicName=B型利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=428c39117525, createdName=839640791, createdTime=Sun Dec 15 10:40:00 CST 2019, time=2019-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781994, encodeId=2e641e81994ea, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Sep 05 22:40:00 CST 2019, time=2019-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366478, encodeId=7f8613664e875, content=<a href='/topic/show?id=76923233335' target=_blank style='color:#2F92EE;'>#利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32333, encryptionId=76923233335, topicName=利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac1c235, createdName=tonychen21, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385220, encodeId=d574138522068, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1800927, encodeId=59a5180092eeb, content=<a href='/topic/show?id=21f8e3220f4' target=_blank style='color:#2F92EE;'>#短期随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73220, encryptionId=21f8e3220f4, topicName=短期随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Mon Jan 14 01:40:00 CST 2019, time=2019-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777186, encodeId=76d71e77186f5, content=<a href='/topic/show?id=824d381e70' target=_blank style='color:#2F92EE;'>#B型利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3817, encryptionId=824d381e70, topicName=B型利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=428c39117525, createdName=839640791, createdTime=Sun Dec 15 10:40:00 CST 2019, time=2019-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781994, encodeId=2e641e81994ea, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Sep 05 22:40:00 CST 2019, time=2019-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366478, encodeId=7f8613664e875, content=<a href='/topic/show?id=76923233335' target=_blank style='color:#2F92EE;'>#利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32333, encryptionId=76923233335, topicName=利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac1c235, createdName=tonychen21, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385220, encodeId=d574138522068, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1800927, encodeId=59a5180092eeb, content=<a href='/topic/show?id=21f8e3220f4' target=_blank style='color:#2F92EE;'>#短期随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73220, encryptionId=21f8e3220f4, topicName=短期随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Mon Jan 14 01:40:00 CST 2019, time=2019-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777186, encodeId=76d71e77186f5, content=<a href='/topic/show?id=824d381e70' target=_blank style='color:#2F92EE;'>#B型利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3817, encryptionId=824d381e70, topicName=B型利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=428c39117525, createdName=839640791, createdTime=Sun Dec 15 10:40:00 CST 2019, time=2019-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781994, encodeId=2e641e81994ea, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Sep 05 22:40:00 CST 2019, time=2019-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366478, encodeId=7f8613664e875, content=<a href='/topic/show?id=76923233335' target=_blank style='color:#2F92EE;'>#利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32333, encryptionId=76923233335, topicName=利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac1c235, createdName=tonychen21, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385220, encodeId=d574138522068, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1800927, encodeId=59a5180092eeb, content=<a href='/topic/show?id=21f8e3220f4' target=_blank style='color:#2F92EE;'>#短期随访#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73220, encryptionId=21f8e3220f4, topicName=短期随访)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Mon Jan 14 01:40:00 CST 2019, time=2019-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777186, encodeId=76d71e77186f5, content=<a href='/topic/show?id=824d381e70' target=_blank style='color:#2F92EE;'>#B型利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3817, encryptionId=824d381e70, topicName=B型利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=428c39117525, createdName=839640791, createdTime=Sun Dec 15 10:40:00 CST 2019, time=2019-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781994, encodeId=2e641e81994ea, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Sep 05 22:40:00 CST 2019, time=2019-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366478, encodeId=7f8613664e875, content=<a href='/topic/show?id=76923233335' target=_blank style='color:#2F92EE;'>#利钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32333, encryptionId=76923233335, topicName=利钠肽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac1c235, createdName=tonychen21, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385220, encodeId=d574138522068, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Jan 11 11:40:00 CST 2019, time=2019-01-11, status=1, ipAttribution=)]

相关资讯

JAHA:心肌肌钙蛋白诊断慢性肾脏病患者急性心肌梗死的性能

由此可见,通过使用基于肌钙蛋白和肌钙蛋白浓度动态变化的算法,改善了高敏感性心肌肌钙蛋白在疑似NSTE-AMI的CKD患者中的诊断性能。

JAHA:肝硬化合并急性心肌梗死患者β受体阻滞剂的选择

由此可见,在肝硬化合并急性心肌梗死患者中,选择β受体阻滞剂是一个临床难题。该研究结果表明使用选择性β1受体阻断剂可降低主要心脏和脑血管事件的风险。

Circulation:年轻女性AMI患者住院人数增加明显

在线发表于《Circulation》杂志上的一项研究显示,1995 ~2014年间,年轻患者的急性心肌梗死(AMI)住院人数有所增加,尤其是女性。

JAMA Network Open:影响中国急性心肌梗死患者重返工作的因素

重返工作岗位是急性心肌梗死患者恢复的重要指标,然而,中国急性心肌梗死后12个月内患者重返工作的比例,以及影响急性心肌梗死后重返工作的相关因素尚未可知。该研究的目的是确定急性心肌梗死后12个月内重返工作的患者比例,并分析患者未返回工作岗位的原因,确定与重返工作岗位相关的因素。

Circulation:高灵敏度心肌肌钙蛋白I与肌钙蛋白T联合应用于急性心肌梗死的早期诊断

结合心肌细胞损伤的两种信号,心肌肌钙蛋白I(cTnI)和T(cTnT),或许可仅采用抽血来克服个别病理生理学和分析的局限性,从而提高对急性心肌梗死的诊断准确性。现研究人员对采用高敏感(hs)cTnI和hs-cTnT联合用于急性心肌梗死的早期诊断价值进行评估。与单独应用相比,hs-cTnI和hs-cTnT联合使用并不能持续提高总体诊断的准确性。但是,联合应用可提高符合早期排除标准的患者比例。根据欧洲

Circulation:主动脉内球囊反搏在心源性休克并发急性心肌梗死患者中的作用

由此可见,IABP对6年长期随访的全因死亡率没有影响。死亡率仍然非常高,尽管当前采用血运重建治疗,仍有三分之二的心源性休克患者死亡。