Heart:心力衰竭诊断中利钠肽水平及其与住院和死亡风险的关系

2021-06-29 MedSci原创 MedSci原创

基线较高的NP水平与HF相关住院率增加和生存率降低相关。

心力衰竭 (HF) 是一种需要紧急治疗的恶性疾病。指南建议在初级保健中进行利钠肽 (NP) 检测,以优先转诊至心内科诊断评估。

近日,心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员旨在评估基线NP与新诊断HF患者住院和死亡率之间的关联。

研究人员对英格兰临床实践研究数据链中40007名新诊断为HF的患者(48%为男性,平均年龄为78.5岁)进行了基于人群的队列研究,并使用了2004年1月1日至2018年12月31日之间的初级和二级医疗保健数据,并根据NP水平报道了住院、1年、5年和10年的死亡率。

生存曲线


22085(55%)名参与者在HF诊断后的一年内住院。较高NP(NT-proBNP>2000pg/mL)水平患者的HF相关住院调整后几率是中度NP(NT-proBNP为400-2000pg/mL)水平患者的两倍(OR为2.26,95%CI为1.98至2.59)。较高的NP水平患者1、5和10年全因死亡率分别为27%、62%和82%,而中度NP水平患者的全因死亡率分别为19%、50%和77%。在竞争风险模型中,每个时间点与HF相关的死亡风险高出50%。NP检测和HF诊断之间的中位时间为101天(IQR为19-581)。
 
由此可见,基线较高的NP水平与HF相关住院率增加和生存率降低相关。尽管医疗保健系统仍面临COVID-19的压力,但迫切需要进一步研究以检验预防住院和改善患者结局的新策略(例如强制性每两周开展HF诊断)。

原始出处:

Clare J Taylor.et al.Natriuretic peptide level at heart failure diagnosis and risk of hospitalisation and death in England 2004–2018.heart.2021.https://heart.bmj.com/content/early/2021/06/28/heartjnl-2021-319196

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    2021-07-02 中医护理人徐

    实用

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    2021-07-01 zhaojie88
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    2021-07-01 slcumt

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