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EHJ:生物标志物有助心脏猝死风险分层

2012-02-04 MedSci MedSci原创

  意大利学者的一项研究表明,C反应蛋白>3 mg/L与心脏猝死(SCD)或快速室性心律失常(VT/VF)无相关性,但为心衰死亡率的有效预测因素。生物标志物与临床标志物一起可对2年死亡率进行良好的危险分层。论文于2012年1月26日在线发表于《欧洲心脏杂志》(Euro Heart J)。   心肌梗死后伴有SCD风险的患者可接受置入型心律转复除颤器(ICD)治疗,但目前尚不清楚血浆生物标志

  意大利学者的一项研究表明,C反应蛋白>3 mg/L与心脏猝死(SCD)或快速室性心律失常(VT/VF)无相关性,但为心衰死亡率的有效预测因素。生物标志物与临床标志物一起可对2年死亡率进行良好的危险分层。论文于2012年1月26日在线发表于《欧洲心脏杂志》(Euro Heart J)。

  心肌梗死后伴有SCD风险的患者可接受置入型心律转复除颤器(ICD)治疗,但目前尚不清楚血浆生物标志物是否有助于对SCD和VT/VF进行风险分层。CAMI-GUIDE研究的主要目标为在射血分数<30%的局部缺血性患者中评估C反应蛋白对SCD和VT/VF的预测价值;次要终点包括全因死亡率、住院和心衰死亡。在预测不良转归的多标志物方法中,将胱蛋白酶抑制剂C和NT-ProBNP整合入附加分析。

  结果显示,共有300例患者被纳入研究。2年时全因死亡率为22.6%,心衰死亡率为8.3%。主要终点发生率为17.3%。对基线变量进行竞争风险多变量分析校正之后,C反应蛋白≤3 mg/L与>3 mg/L的患者在主要终点方面无显著差异,但C反应蛋白>3 mg/L与心衰死亡率显著相关(P=0.002)。均值以上NT-ProBNP与主要终点显著相关(P=0.042)。包括三种生物标志物、NYHA分级和静息心率在内的风险函数可对死亡风险介于5至50%的患者进行分层。

  链接:

  Risk stratification of ischaemic patients with implantable cardioverter defibrillators by C-reactive protein and a multi-markers strategy: results of the CAMI-GUIDE study

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