JAHA:BNP与冠心病患者长期心血管死亡率的关系

2022-07-01 MedSci原创 MedSci原创

BNP浓度仍是心血管死亡率的独立预测因子。由于血浆浓度的随机变化,平均1次以上的BNP测量可改善患者长期风险预测。

血浆中B型利钠肽(BNP)及其前肽、BNP前体N末端(NT-pro-BNP)浓度与不同人群(包括冠心病患者)的心血管死亡、心力衰竭和卒中风险相关。BNP和NT-pro-BNP对不良心血管事件的预测价值强于大多数其他生物标志物。通过识别较高的不良心血管事件风险患者,测量BNP水平可能有助于更好地针对更有获益潜力的患者进行心血管预防治疗。BNP浓度是不良心血管事件的一个强有力的预测指标。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究的目的是确定血浆BNP浓度与心血管死亡率之间的关系是持续的还是随着测定BNP后时间的延长而降低。

6740例有心肌梗死或不稳定心绞痛病史的患者参与了长期普伐他汀干预缺血性疾病(LIPID)试验,在基线和1年后检测了血浆BNP浓度。随机化分组后1-5年、5-10年和10-16年,研究人员通过里程碑式分析评估了心血管死亡率的相关性。

该研究共有1640例心血管疾病死亡。基线后1年至5年、5年至10年和10年至16年,心血管死亡率分别从10.2至19.1至26.3/1000例患者每年递增。

与基线或仅1年BNP浓度相比,基线和1年BNP浓度的平均值与心血管死亡率的相关性更强。在1~5年(HR为1.53[95%CI为1.44-1.63])、5~10年(HR为1.52[95%CI为1.44-1.60])和10~16年(HR为1.43[95%CI为1.36-1.50])心血管死亡的风险比(HR)相似,所有P<0.0001。

由此可见,在测量十多年后,BNP浓度仍是心血管死亡率的独立预测因子。由于血浆浓度的随机变化,平均1次以上的BNP测量可改善患者长期风险预测。

原始出处:

Ralph A. H. Stewart.et al.B‐Type Natriuretic Peptide and Long‐Term Cardiovascular Mortality in Patients With Coronary Heart Disease.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.121.024616

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    2022-07-03 ms2000001980585227

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    2022-07-03 zhaohui6731
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    2022-07-03 huiwelcome
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    2022-07-02 ms5000000518166734

    学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习

    0

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