严重主动脉瓣狭窄的 TAVI 患者中 N-乙酰葡糖苷酶和肾损伤分子-1 的预后价值。

IF 1.9 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Biomarkers in medicine Pub Date : 2024-11-18 DOI:10.1080/17520363.2024.2429366

Congde Xu, Nastasia Roth, Carolin Heidel, Ute Hubauer, Stefan Wallner, Ralph Burkhardt, Christine Meindl, Andreas Holzamer, Michael Hilker, Marcus Creutzenberg, Samuel Sossalla, Lars Maier, Kurt Debl, Carsten Jungbauer

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引用次数: 0

摘要

目的：心肾综合征（CRS）常见于重度主动脉瓣狭窄（AS）患者。先前的研究显示，N-乙酰葡糖苷酶（NAG）和肾损伤分子-1（KIM-1）是 CRS 的潜在标志物。本研究旨在探讨NAG、KIM-1和NT-proBNP在TAVI手术前对重症AS的预后能力：研究收集了151名患者在TAVI术前的血浆和尿液样本。进行了长期随访（中位随访时间为 31 个月），以评估全因死亡率以及死亡率和充血性心力衰竭的复合终点：结果：与其他严重 AS 表型相比，经典低流量、低梯度 AS 的 NT-proBNP 明显升高（P = n.s.）。随访期间，40 名患者（26.5%）死亡，58 名患者（38.4%）达到综合终点。在Kaplan-Meier分析中，NAG和KIM-1基线水平升高与NT-proBNP一样，与全因死亡风险增加有关（各ppp=n.s.）：结论：基线NAG以及KIM-1和NT-proBNP对TAVI术前重度AS患者的全因死亡率有显著的预测价值，但程度较低。

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Prognostic value of N-Acetylglucosaminidase and Kidney-injury-molecule-1 in TAVI patients with severe aortic stenosis.

Aim: Cardiorenal syndrome (CRS) is common in severe aortic stenosis (AS). Previous studies revealed N-Acetylglucosaminidase (NAG) and Kidney-injury-molecule-1 (KIM-1) as potential markers for CRS. The study aimed to investigate the prognostic capability of NAG, KIM-1, NT-proBNP in severe AS before TAVI.

Materials & methods: Plasma and urine samples were collected from 151 participants before TAVI. Long-term follow-up (median follow-up time 31 months) was conducted to assess all-cause mortality and a composite endpoint of mortality and congestive heart failure.

Results: NT-proBNP was significantly elevated in classical low-flow, low-gradient AS compared to other severe AS phenotypes (p < 0.01), unlike NAG and KIM-1 (each p = n.s.). During follow-up, 40 patients (26.5%) died, and 58 patients (38.4%) reached the composite endpoint. Elevated baseline levels of NAG and KIM-1 were associated with increased risk of all-cause mortality in Kaplan-Meier analysis, like NT-proBNP (each p<0.05). NAG and STS-Score were revealed as significant predictors for all-cause mortality in multivariable COX-regression analysis (each p<0.05), unlike NT-proBNP, KIM-1, eGFR, and clinical parameters (each p=n.s.).

Conclusion: Baseline NAG and, to a lesser degree, KIM-1 and NT-proBNP provide significant predictive value for all-cause mortality in patients with severe AS before TAVI.

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来源期刊

Biomarkers in medicine 医学-医学：研究与实验

CiteScore

3.80

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory. Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice. As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications. Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest. Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.