摘要
目的 探讨入院即刻N末端B型钠尿肽原(NT-proBNP)对不稳定性心绞痛患者左心室射血分数(LVEF)和院内主要不良心脑血管事件(MACCE)的预测价值.方法 回顾性连续入选2013年1月至2017年9月于北京友谊医院心内科住院的不稳定性心绞痛患者2 972例,按入院即刻血浆NT-proBNP四分位水平分为4组,即NT-proBNP<61 ng/L组(733例)、61 ng/L≤NT-proBNP<133 ng/L组(749例)、133 ng/L≤NT-proBNP<326 ng/L组(747例)和NT-proBNP≥326ng/L组(743例).收集入选者的相关临床资料.比较各组患者LVEF水平和院内MACCE发生情况.采用多因素logistic回归分析NT-proBNP对不稳定性心绞痛患者LVEF和院内MACCE的预测价值.结果 随着NT-proBNP水平升高,患者LVEF降低[NT-proBNP<61 ng/L组、61 ng/L≤NT-proBNP<133 ng/L组、133 ng/L≤NT-proBNP<326 ng/L组和NT-proBNP≥326 ng/L组患者LVEF分别为(68.4±4.8)%、(68.2±5.2)%、(67.2±6.7)%和(62.6±10.4)%,F=77.98,P<0.01].随着NT-proBNP水平升高,院内MACCE发生率升高[NT-proBNP<61 ng/L组、61 ng/L≤NT-proBNP<133 ng/L组、133 ng/L≤NT-proBNP<326 ng/L组和NT-proBNP≥326 ng/L组患者院内MACCE发生率分别为3.4%(25/733)、3.5%(26/749)、5.5%(41/747)和7.3%(54/743),x2=16.23,P<0.01].多因素logistic回归分析结果显示,NT-proBNP是LVEF<50%的独立预测因子[Exp(β)=5.875,95%CI 3.382~10.207,P<0.001],但不是院内MACCE的独立预测因子[Exp(β)=0.783,95 %CI 0.400~1.996,P=0.783].结论 入院即刻血浆NT-proBNP水平是不稳定性心绞痛患者LVEF的独立预测因子,但不是院内MACCE的独立预测因子.
Objective To explore the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on admission on left ventricular ejection fraction (LVEF) and the in-hospital major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients with unstable angina (UA).Methods Data of 2 972 consecutive hospitalized patients with UA in Beijing Friendship Hospital from January 2013 to September 2017 were retrospective analyzed.Patients were divided into 4 groups according to the level of NT-proBNP on admission:733 cases with NT-proBNP lower than 61 ng/L,749 cases with NT-proBNP between 61 and 133 ng/L,747 cases with NT-proBNP between 133 and 326 ng/L,and 743 cases with NT-proBNP higher than 326 ng/L.LVEF and in-hospital MACCE were compared among 4 groups and the predictive value of NT-proBNP on admission on LVEF and in-hospital MACCE was determined by multiple logistical regression analysis.Results LVEF value became lower with increasing on admission NT-proBNP value ((68.4± 4.8) %,(68.2 ± 5.2)%,(67.2 ± 6.7)% and (62.6± 10.4)%,F=77.98,P<0.0 1),while in-hospital MACCE was higher with increasing on admission NT-proBNP value (3.4% (25/733),3.5% (26/749),5.5%(41/747)and 7.3% (54/743),χ^2=16.23,P<0.01) in NT-proBNP lower than 61 ng/L,NT-proBNP between 61 and 133 ng/L,NT-proBNP between 133 and 326 ng/L,and NT-proBNP higher than 326 ng/L group.Multiple logistic regression analysis showed that on admission NT-proBNP was an independent predictor for LVEF<50% (Exp(β)=5.875,95%CI 3.382-10.207,P<0.001),but not predictor for in-hospital MACCE (Exp(β) =0.783,95%CI 0.400-1.996,P=0.783).Conclusion The on admission NT-proBNP level is an independent predictor of left ventricular systolic dysfunction (LVEF<50%),but not an independent predictor of total in-hospital MACCE in hospitalized patients with UA.
作者
高翔宇
陈晖
丁晓松
武珊珊
魏巍
李虹伟
Gao Xiangyu;Chen Hui;Ding Xiaosong;WU Shanshan;Wei Wei;Li Honguei(Cardiovascular Center. Beijing Friendship Hospital. Capital Medical I niversify, Beijing 100050, China;National Clinical Research Center of Digestive Diseases, Beijing 100050, China)
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2019年第2期117-122,共6页
Chinese Journal of Cardiology
基金
首都医科大学附属北京友谊医院科研启动基金(yyqdkt2017-34).
关键词
心绞痛
不稳定型
利钠肽
脑
预后
Angina,unstable
Natriuretic peptide,biain
Prognosis