IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2025-02-28 DOI:10.3390/diagnostics15050589
Liviu Cristescu, Dragos-Gabriel Iancu, Marius-Stefan Marusteri, Ioan Tilea, Andreea Varga
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引用次数: 0

摘要

背景/目标:慢性心力衰竭(CHF)仍然是全球重大的健康负担,发病率高、住院时间长、死亡率高。传统的生物标志物(如 NT-proBNP)具有预后价值;然而,新的生物标志物比值可加强风险分层。本研究评估了 NT-proBNP-白蛋白比值(NTAR)、红细胞分布宽度-eGFR 比值(RGR)和红细胞分布宽度-纤维蛋白原比值(RFR)对住院时间(LOS)、延长住院时间(ELOS)、院内死亡率和 6 个月全因死亡率的预测作用。研究方法对 382 例 CHF 住院病例(2022-2024 年)进行了回顾性观察试验研究,并进行了全面的实验室评估。通过单变量和多变量逻辑回归、接收器操作特征曲线和考克斯比例危害逐步分析法评估生物标志物的性能,以完善预测模型。结果:NTAR和RGR是住院结果的重要预测指标。NTAR 与 LOS 延长呈中度相关(r = 0.45,p < 0.001),是 ELOS 的独立预测因子(AUC = 0.697,OR = 2.438,p < 0.001),优于 NT-proBNP。此外,NTAR 可显著预测院内死亡率(AUC = 0.768,OR = 4.461,p < 0.001)和 6 个月全因死亡率(AUC = 0.766,OR = 4.185,p < 0.001)。RGR是院内死亡率的最强预测因子(AUC = 0.785,HR = 2.18,p = 0.005),突出了其在CHF肾功能障碍和红细胞生成改变中的作用。观察到的 RFR 预后价值很小。结论在我们的研究中,NTAR 和 RGR 提供了宝贵的预后价值,强调了心脏负荷、营养状况和肾功能在 CHF 预后中的相互作用。有必要对这些生物标志物进行进一步的多中心验证。
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Proposed Novel Heart Failure Biomarkers and Their Association with Length of Hospital Stay and Mortality: A Retrospective Observational Pilot Study.

Background/Objectives: Chronic heart failure (CHF) remains a significant global health burden, with high morbidity, prolonged hospitalizations, and increased mortality. Traditional biomarkers such as NT-proBNP provide prognostic value; however, novel biomarker ratios may enhance risk stratification. This study evaluated the predictive utility of the NT-proBNP-to-albumin ratio (NTAR), red cell distribution width-to-eGFR ratio (RGR), and red cell distribution width-to-fibrinogen ratio (RFR) for hospital length of stay (LOS), extended hospitalization (ELOS), in-hospital mortality, and 6-month all-cause mortality. Methods: A retrospective observational pilot study was conducted on 382 CHF admissions (2022-2024) with comprehensive laboratory assessment. Biomarker performance was assessed through uni- and multivariate logistic regression, receiver operating characteristic curve, and Cox proportional hazards stepwise methods of analyses for refining predictive models. Results: NTAR and RGR emerged as significant predictors of hospitalization outcomes. NTAR demonstrated a moderate correlation with prolonged LOS (r = 0.45, p < 0.001) and was an independent predictor of ELOS (AUC = 0.697, OR = 2.438, p < 0.001), outperforming NT-proBNP. Additionally, NTAR significantly predicted in-hospital mortality (AUC = 0.768, OR = 4.461, p < 0.001) and 6-month all-cause mortality (AUC = 0.766, OR = 4.185, p < 0.001). RGR was the strongest predictor of in-hospital mortality (AUC = 0.785, HR = 2.18, p = 0.005), highlighting its role in renal dysfunction and erythropoietic alterations in CHF. The RFR observed prognostic value was minimal. Conclusions: In our study, NTAR and RGR offered valuable prognostic value underscoring the interplay of cardiac stress, nutritional status, and renal function in CHF prognosis. Further multicenter validation is warranted for these biomarkers.

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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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