Eur Respir J:稳定性COPD患者高敏感性肌钙蛋白I与全因死亡率

2019-12-14 xing.T MedSci原创

在稳定性COPD患者中,hs-TnI是全因死亡率的有力预测指标,已超出既定的COPD死亡率预测指标,且不受一系列的心血管危险因素和已患的心血管疾病影响。如果将hs-TnI浓度添加到既定的风险评估中,其可为COPD患者提供进一步的预后价值。

慢性阻塞性肺疾病(COPD)是导致死亡的主要原因,其中很大一部分人死于心血管疾病。高敏感性肌钙蛋白I(hs-TnI)可能有助于更好地识别高死亡率的COPD患者。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,研究人员旨在探究稳定COPD人群hs-TnI浓度对既定COPD评估以外全因死亡率的预测价值,并在考虑了相关的心血管危险因素和普遍的心血管疾病之后,对hs-TnI的预测价值进行评估。

研究人员对参与多中心COSYCONET队列研究的各个严重程度阶段的2085例稳定性COPD患者进行了hs-TnI浓度、广泛的呼吸和心血管标志物评估。该研究的主要结局是随访3年以上的全因死亡率。

2020例(96.9%)患者可检测到hs-TnI。hs-TnI的中位浓度为3.8 ng·L-1(IQR为2.5-6.6 ng·L-1),在1.8%的患者中观察到的水平高于第99个百分位数27% ng·L-1这一参考极限。在Cox回归分析中,包括对气流受限、呼吸困难等级、运动能力和严重加重病史的调整,以及传统的心血管危险因素、估计的肾小球滤过率、踝臂指数、脑钠肽前体N末端和已患的心血管疾病,hs-TnI可以作为连续变量(log hs-TnI的HR为1.28 [95%CI为1.01‒1.62])进行连续预测,并且可以根据阈值进行分类 6 ng·L-1(HR为1.63 [95%CI为1.10‒2.42])。

在稳定性COPD患者中,hs-TnI是全因死亡率的有力预测指标,已超出既定的COPD死亡率预测指标,且不受一系列的心血管危险因素和已患的心血管疾病影响。如果将hs-TnI浓度添加到既定的风险评估中,其可为COPD患者提供进一步的预后价值。 

原始出处:

Benjamin Waschki,et al.High-sensitivity troponin I and all-cause mortality in patients with stable COPD: An analysis of the COSYCONET study.Eur Respir J.2019.https://erj.ersjournals.com/content/early/2019/11/13/13993003.01314-2019

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    2019-12-16 gous
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    2019-12-15 飛歌

    学习了很有用不錯

    0