nesfatin-1对心力衰竭死亡率的预测价值

M. Kerkutluoglu, H. Gunes, Ali Eren Onus, M. Dagli, O. Yucel
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摘要

摘要目的晚期心力衰竭是心力衰竭的最后阶段,患者的预期寿命明显降低。在晚期心力衰竭中已经发现了许多死亡标志。虽然nesfatin-1分子被认为是一种饱腹感激素,但它也被证明与许多心血管疾病有关。本研究旨在探讨晚期心力衰竭患者住院死亡率与nesfatin-1水平的关系。方法对74例晚期心力衰竭患者进行回顾性分析。在这些患者的冠状动脉重症监护监测期间,22例患者发生院内死亡。将这些病例分为有住院死亡率和无住院死亡率两组,使用实验室数据、超声心动图和人口统计学特征对其进行比较。结果院内死亡病例年龄大于无死亡病例[74(66 ~ 95)比67 (26 ~ 90)];p = 0.019)。住院死亡组血清nesfatin-1水平和三尖瓣环面收缩偏移(TAPSE)均较低(43.8±5.5∶40.5±6.1;P =0.027, 13.5±1.9 vs. 16.2±2.6 P =0.001)。血清nesfatin-1水平和TAPSE通过多变量分析检测为晚期心力衰竭住院死亡率的独立预测因子,使用单变量分析中显著的参数。受试者特征曲线分析显示,Nesfatin-1测定院内死亡率的最佳临界值≤23.57 (pg/mL),特异性为73.1 %,敏感性为77.3 % (AUC=0.763, 95 % CI= 0.647-0.879, p<0.001)。本研究表明,在晚期心力衰竭患者中,血清nesfatin-1含量与死亡率相关,似乎是死亡率的独立预测因子。
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Predictive value of nesfatin-1 in heart failure mortality
Abstract Objectives Advanced heart failure is the last stage of heart failure in which the life expectancy of patients is significantly reduced. Many mortality markers have been identified in advanced heart failure. Although the nesfatin-1 molecule is known as a satiety hormone, it has also been shown to be associated with many cardiovascular diseases. This study aims to elucidate the association between in-hospital mortality and nesfatin-1 level in advanced heart failure patients. Methods The research included 74 cases of advanced heart failure. During the coronary intensive care surveillance of these patients, 22 patients had in-hospital mortality. The cases, divided into groups with and without in-hospital mortality, were compared using laboratory data, echocardiography, and demographic properties. Results The age of the cases with in-hospital mortality was older than the cases without mortality [(74 (66–95) vs. 67 (26–90); p=0.019)]. Serum nesfatin-1 level and tricuspid annular plane systolic excursion (TAPSE) were statistically lower in the in-hospital mortality group (43.8 ± 5.5 vs. 40.5 ± 6.1; p=0.027, 13.5 ± 1.9 vs. 16.2 ± 2.6 p=0.001, respectively). Serum nesfatin-1 level and TAPSE were detected as independent predictors for in-hospital mortality in advanced heart failure via multivariate analysis using parameters that were significant in the univariate analysis. Receiver operator characteristic curve analysis showed that the optimum cut-off level for Nesfatin-1 in determining in-hospital mortality was ≤23.57 (pg/mL) with a specificity of 73.1 % and a sensitivity of 77.3 % (AUC=0.763, 95 % CI=0.647–0.879, p<0.001). Conclusions This research revealed that in advanced heart failure patients, serum nesfatin-1 amounts are associated with mortality and seem to be an independent predictor of mortality.
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