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JAHA:白蛋白尿作为急性心肌梗死患者心血管预后的预测因子

2019-04-05 xing.T 网络

由此可见,在MI患者中,白蛋白尿是后续结局的有效预测因子,这表明在这一高危人群中,除了肾功能外,还要注意患者白蛋白尿的信息。

在心肌梗塞(MI)患者中,肾功能降低被认为是预后不良的重要预测因子,但白蛋白尿(肾脏损伤的代表性指标)的影响尚未得到广泛评估。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,在SCREAM(斯德哥尔摩肌酐测量)项目(2006-2012)中,研究人员确定了2469名MI患者,其中在MI前一年内测量了试纸蛋白尿(427名患者同时测量了尿白蛋白与肌酐比[ACR]),并获得了仅有试纸蛋白尿的参与者估计的ACR。研究人员使用Cox模型量化了ACR与MI后全因死亡率、血管死亡率、复发性MI、缺血性卒中或心力衰竭复合和单个结局之间的关联,然后评估了C统计量的改善情况。

在MI后1.0年的中位随访期间,1607名(65.1%)参与者发生了MI后复合结局。除缺血性卒中外,较高的ACR水平与所有结局独立相关。ACR每增加8倍(例如,40 vs. 5mg/g),复合结局的风险比为1.21(95%CI为1.08-1.35)。ACR的加入改善了MI后复合结局C统计量为0.040(95%CI为0.030-0.051)。无论糖尿病状态如何,并且在没有插补的情况下单独分析ACR或试纸结果,都获得了大致相似的结果。

由此可见,在MI患者中,白蛋白尿是后续结局的有效预测因子,这表明在这一高危人群中,除了肾功能外,还要注意患者白蛋白尿的信息。

原始出处:


Yejin Mok.et al.Albuminuria as a Predictor of Cardiovascular Outcomes in Patients With Acute Myocardial Infarction.JAHA.2019.https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010546

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    2019-04-22 HLL1980

    长见识啦,谢谢分享。

    0

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    2019-04-07 zhaohui6731
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    2019-04-07 珙桐
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  5. [GetPortalCommentsPageByObjectIdResponse(id=365052, encodeId=b7d8365052a8, content=长见识啦,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c6d1682658, createdName=HLL1980, createdTime=Mon Apr 22 00:41:51 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268113, encodeId=58ea12681135e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304642, encodeId=f6f81304642be, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310722, encodeId=f1b81310e2232, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377106, encodeId=14f413e710623, content=<a href='/topic/show?id=ae99e1769f9' target=_blank style='color:#2F92EE;'>#白蛋白尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71769, encryptionId=ae99e1769f9, topicName=白蛋白尿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508636, encodeId=95b31508636ed, content=<a href='/topic/show?id=884c51916cd' target=_blank style='color:#2F92EE;'>#心血管预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51916, encryptionId=884c51916cd, topicName=心血管预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de8d9990502, createdName=xiaogang320, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364183, encodeId=1167364183cd, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 05 22:42:10 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364181, encodeId=36cb364181f7, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 05 22:25:16 CST 2019, time=2019-04-05, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=365052, encodeId=b7d8365052a8, content=长见识啦,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c6d1682658, createdName=HLL1980, createdTime=Mon Apr 22 00:41:51 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268113, encodeId=58ea12681135e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304642, encodeId=f6f81304642be, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310722, encodeId=f1b81310e2232, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377106, encodeId=14f413e710623, content=<a href='/topic/show?id=ae99e1769f9' target=_blank style='color:#2F92EE;'>#白蛋白尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71769, encryptionId=ae99e1769f9, topicName=白蛋白尿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508636, encodeId=95b31508636ed, content=<a href='/topic/show?id=884c51916cd' target=_blank style='color:#2F92EE;'>#心血管预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51916, encryptionId=884c51916cd, topicName=心血管预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de8d9990502, createdName=xiaogang320, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364183, encodeId=1167364183cd, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 05 22:42:10 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364181, encodeId=36cb364181f7, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 05 22:25:16 CST 2019, time=2019-04-05, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=365052, encodeId=b7d8365052a8, content=长见识啦,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c6d1682658, createdName=HLL1980, createdTime=Mon Apr 22 00:41:51 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268113, encodeId=58ea12681135e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304642, encodeId=f6f81304642be, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310722, encodeId=f1b81310e2232, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377106, encodeId=14f413e710623, content=<a href='/topic/show?id=ae99e1769f9' target=_blank style='color:#2F92EE;'>#白蛋白尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71769, encryptionId=ae99e1769f9, topicName=白蛋白尿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508636, encodeId=95b31508636ed, content=<a href='/topic/show?id=884c51916cd' target=_blank style='color:#2F92EE;'>#心血管预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51916, encryptionId=884c51916cd, topicName=心血管预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de8d9990502, createdName=xiaogang320, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364183, encodeId=1167364183cd, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 05 22:42:10 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364181, encodeId=36cb364181f7, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 05 22:25:16 CST 2019, time=2019-04-05, status=1, ipAttribution=)]
    2019-04-05 天地飞扬

    了解一下,谢谢分享!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=365052, encodeId=b7d8365052a8, content=长见识啦,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c6d1682658, createdName=HLL1980, createdTime=Mon Apr 22 00:41:51 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268113, encodeId=58ea12681135e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304642, encodeId=f6f81304642be, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310722, encodeId=f1b81310e2232, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377106, encodeId=14f413e710623, content=<a href='/topic/show?id=ae99e1769f9' target=_blank style='color:#2F92EE;'>#白蛋白尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71769, encryptionId=ae99e1769f9, topicName=白蛋白尿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508636, encodeId=95b31508636ed, content=<a href='/topic/show?id=884c51916cd' target=_blank style='color:#2F92EE;'>#心血管预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51916, encryptionId=884c51916cd, topicName=心血管预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de8d9990502, createdName=xiaogang320, createdTime=Sun Apr 07 11:06:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364183, encodeId=1167364183cd, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 05 22:42:10 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364181, encodeId=36cb364181f7, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 05 22:25:16 CST 2019, time=2019-04-05, status=1, ipAttribution=)]
    2019-04-05 一个字-牛

    学习了谢谢分享

    0

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由此可见,无论肾功能如何,尿中白蛋白升高与NSTEMI和STEMI的高风险相关,而单独降低的肾功能与更高的NSTEMI风险相关。

Diabetologia:白蛋白尿或可预测T1DM早期心功能异常

心力衰竭是1型糖尿病患者死亡的主要原因之一。因此,心力衰竭早期诊断对1型糖尿病至关重要。 为此,来自丹麦Steno糖尿病中心的Jensen教授及其团队进行了一项研究,试图确定在没有已知心脏病的1型糖尿病患者中,亚临床心脏收缩和舒张功能受损相关的患病率和临床特征。该研究结果发表在2014年04月的Diabetologia杂志上。 该研究是一项横断面调查,从Steno糖尿病中心随机选择了1093例

DIABETOLOGIA:非白蛋白尿肾功能损害可作为2型糖尿病患者死亡率的强预测因子?

非蛋白尿性肾损伤已成为2型糖尿病患者中普遍存在的糖尿病肾病(DKD)表型,其估计GFR(eGFR)<60 ml min -1 1.73 m -2。在本研究中,研究人员比较了具有这种表型和蛋白表型的个体的全因死亡率和决定因素。 在2006 - 2008年,这项观察性前瞻性队列研究共招募了15,773名患有2型糖尿病的个体。基于基线白蛋白尿和eGFR分类为:没

DIABETOLOGIA:2型糖尿病患者因心力衰竭住院的风险过高

2型糖尿病是心力衰竭的既定的风险因素,但目前仍缺乏相关的年龄特异性数据。本研究的目的是与来自一般人群的年龄和性别匹配的对照个体进行比较,确定基于年龄,血糖控制和肾功能的心力衰竭的过度风险。 研究人员将1998 - 2012年瑞典国家糖尿病登记处(n  = 266,305)登记的2型糖尿病患者与未患糖尿病的年龄,性别和县匹配对照组进行比较(n  = 1,323,504),随

Am J Resp Crit Care:白蛋白尿、肺功能下降与COPD风险

由此可见,在基于人群的样本中,白蛋白尿与更大的肺功能下降、肺活量测定定义的COPD以及COPD相关事件之间存在相关性。

CDS2018:白蛋白尿的重新认识:另一种心肾风险因素?老外专家带您了解一下

糖尿病患者更容易患上肾脏并发症,目前对于糖尿病肾病管理的意识越来越强烈。越来越多的研究打破了原来对白蛋白尿的认识,对于糖尿病肾病管理起到一定的启示作用。

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