J Thromb Haemost:抗凝治疗的房颤患者白细胞介素-6与死亡风险

2020-06-11 MedSci原创 MedSci原创

通过重复进行IL-6测量,持续性全身炎症活性与死亡率相关,而在抗凝治疗的AF患者的其他已知的临床危险因素和心血管生物标志物无关。

炎性生物标志物白细胞介素-6(IL-6)与心房颤动(AF)患者死亡率有关。近日,血栓和凝血疾病权威杂志Journal of Thrombosis and Haemostasis上发表了一篇研究文章,该研究旨在调查重复IL-6测量是否能改善抗凝AF患者卒中或全身性栓塞、大出血和死亡的预测。

在中位随访时间为1.8年的ARISTOTLE试验中,研究人员对4830名患者入组时和2个月时通过ELISA检测了IL-6水平。在RE‐LY试验中,研究人员分别于3、6、12个月时对2559例患者的IL-6进行了测量,并通过Cox回归分析了第二次IL-6测量值与结局之间的相关性,并针对基线IL-6、临床变量和其他血管生物标志物进行了调整。

在ARISTOTLE试验的两个时间点IL-6水平中位数分别为2.0 ng/L(四分位数范围[IQR]为1.30-3.20)和2.10 ng/L(IQR为1.40-3.40),而在RE-LY试验中分别为2.5 ng/L(IQR为1.6-4.3)、2.5 ng/L(IQR为1.6-4.2)、2.4 ng/L(IQR为1.6-3.9)和2.4 ng/L(IQR为1.5-3.9)。IL-6与死亡率有关。2个月或3个月IL-6升高50%的风险比在ARISTOTLE试验中为1.32(95%CI为1.23-1.41,p<0.0001)和在RE‐LY试验中为1.11(1.01-1.22,p=0.0290);在ARISTOTLE试验中C指数从0.74提高到0.76,但在RE-LY队列中却没有增加。第二次IL-6测量值和卒中或全身性栓塞或大出血之间没有一致的相关性。

由此可见,通过重复进行IL-6测量,持续性全身炎症活性与死亡率相关,而在抗凝治疗的AF患者的其他已知的临床危险因素和血管生物标志物无关。

原始出处:

Julia Aulin.et al.Serial measurement of interleukin‐6 and risk of mortality in anticoagulated patients with atrial fibrillation: Insights from ARISTOTLE and RE‐LY trials.Journal of Thrombosis and Haemostasis.2020.https://doi.org/10.1111/jth.14947

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    2021-01-24 changfy
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    2020-06-11 心介

    房颤,临床上碰到很多哦

    0

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