Hypertension:NT-proBNP水平的变化与痴呆风险

2019-12-24 xing.T MedSci原创

由此可见,NT-proBNP的增加与未来全因住院的痴呆症独立相关,并且与危险因素和基线NT-proBNP相比,对痴呆症风险具有中等的预测价值。

横截面测量的B型利尿钠肽前体N末端(NT-proBNP)与痴呆发生有关。然而,缺乏将NT-proBNP变化与未来痴呆症风险联系起来的数据。近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员旨在探究NT-proBNP3.2年以上的变化与痴呆之间的关系。

研究人员纳入了4563名多民族动脉粥样硬化研究(MESA)前瞻性队列参与者,这些参与者在入组时无心血管疾病,在MESA第1次(基线,2000-2002)和第3次(2004-2005)评估中测得NT-proBNP水平,并且在第3次评估前没有诊断为痴呆。研究人员使用竞争风险COX比例风险回归分析评估MESA第1次和第3次NT-proBNP水平变化与第3次(2004-2004年)评估到2015年期间全因住院痴呆(根据第九版国际疾病分类代码)之间的相关性。

在45522人次每年的随访期间,研究人员共记录了223例痴呆病例。MESA第1次至第3次评估的log-NT-proBNP增加与痴呆症发生呈正相关(多变量风险比为1.28 [95%CI为1.001-1.64]; P=0.049)。MESA第1次至第3次评估NT-proBNP水平至少增加25%,与多变量分析中痴呆症风险增加55%相关(P=0.02)。将NT-proBNP的时间变化添加到包括危险因素和基线NT-proBNP的模型中,可以改善痴呆症的预测(Harrell C统计量从0.85升至0.87,P=0.049)。

由此可见,NT-proBNP的增加与未来全因住院的痴呆症独立相关,并且与危险因素和基线NT-proBNP相比,对痴呆症风险具有中等的预测价值。

原始出处:

Mohammad R. Ostovaneh.et al.Change in NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) Level and Risk of Dementia in Multi-Ethnic Study of Atherosclerosis (MESA).Hypertension.2019.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13952

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    2020-06-29 feather89
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    2019-12-26 huiwelcome
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    2019-12-26 mjldent
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    2019-12-26 sunylz
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    2019-12-24 junJUN

    老年人痴呆何药可用??

    0

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由此可见,在没有卒中的欧洲人群中,NT-proBNP水平与缺血性和出血性卒中的风险呈正相关,与其他几种危险因素和病症无关。将NT-proBNP添加到已知的风险评分变量中可改善卒中的预测,具有中等效应的大小。

JAHA:NT-proBNP与房颤发生风险种族差异相关

黑种人的心血管疾病风险因素要多于白种人,但房颤的发生率却低于白种人,相反,白种人的心衰风险更低。在白人中,N末端前B型钠尿肽(NT-proBNP)水平较高,可预测房颤的发生,并在心室舒张压升高的情况下具有利尿作用,这可能为这些种族差异提供统一的解释。本研究纳入了4731名CHS临床研究中参与者(770名黑种人)和12418名ARIC临床研究的参与者(3091名黑种人),其中分别有1277名和125

Circulation:NT-proBNP与肺动脉高压患者长期预后的相关性

在肺动脉高压(PAH)指南中,NT-proBNP(N末端脑利钠肽前体)水平被作为PAH评估的风险之一。但目前缺乏支持采用NT-proBNP风险阈值来评估PAH预后的数据。GRIPHON试验(PAH中的前列环素[PGI2]受体激动剂)对NT-proBNP阈值的预后意义进行评估,同时评估了根据其阈值患者对PGI2受体激动剂selexipag(治疗肺动脉高压的药物)的反应。将受试患者随机分至selexi

Int J Cardiol:入院时高敏肌钙蛋白T和NT-proBNP用于急性心力衰竭的预后判断

由此可见,最佳的NT-proBNP临界值(4382ng/L)可独立预测结局,而最佳的hs-TnT(55ng/L)则不能。生物标志物超过临界值的患者住院死亡率高出12倍。入院时hs-TnT≥43ng/L和最佳hs-TnT临界值对出院后结局具有独立的预后意义,而hs-TnT在考虑绝对值时似乎不如NT-proBNP的预测能力。

Heart:射血分数保留vs.射血分数降低心衰患者的预后和NT-proBNP

这项研究强调并证实了NT-proBNP水平在HFpEF患者中可以提供与HFrEF相同的相对风险信息。

PLos One:NT-proBNP预测慢性心衰患者两年预后的价值

在慢性心衰患者中使用考虑到利尿钠肽的预测模型,应成为常规临床实践的标准。