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Eur Respir J:稳定性COPD患者高敏感性肌钙蛋白I与全因死亡率

2019-12-14 xing.T MedSci原创

在稳定性COPD患者中,hs-TnI是全因死亡率的有力预测指标,已超出既定的COPD死亡率预测指标,且不受一系列的心血管危险因素和已患的心血管疾病影响。如果将hs-TnI浓度添加到既定的风险评估中,其可为COPD患者提供进一步的预后价值。

慢性阻塞性肺疾病(COPD)是导致死亡的主要原因,其中很大一部分人死于心血管疾病。高敏感性肌钙蛋白I(hs-TnI)可能有助于更好地识别高死亡率的COPD患者。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,研究人员旨在探究稳定COPD人群hs-TnI浓度对既定COPD评估以外全因死亡率的预测价值,并在考虑了相关的心血管危险因素和普遍的心血管疾病之后,对hs-TnI的预测价值进行评估。

研究人员对参与多中心COSYCONET队列研究的各个严重程度阶段的2085例稳定性COPD患者进行了hs-TnI浓度、广泛的呼吸和心血管标志物评估。该研究的主要结局是随访3年以上的全因死亡率。

2020例(96.9%)患者可检测到hs-TnI。hs-TnI的中位浓度为3.8 ng·L-1(IQR为2.5-6.6 ng·L-1),在1.8%的患者中观察到的水平高于第99个百分位数27% ng·L-1这一参考极限。在Cox回归分析中,包括对气流受限、呼吸困难等级、运动能力和严重加重病史的调整,以及传统的心血管危险因素、估计的肾小球滤过率、踝臂指数、脑钠肽前体N末端和已患的心血管疾病,hs-TnI可以作为连续变量(log hs-TnI的HR为1.28 [95%CI为1.01‒1.62])进行连续预测,并且可以根据阈值进行分类 6 ng·L-1(HR为1.63 [95%CI为1.10‒2.42])。

在稳定性COPD患者中,hs-TnI是全因死亡率的有力预测指标,已超出既定的COPD死亡率预测指标,且不受一系列的心血管危险因素和已患的心血管疾病影响。如果将hs-TnI浓度添加到既定的风险评估中,其可为COPD患者提供进一步的预后价值。 

原始出处:

Benjamin Waschki,et al.High-sensitivity troponin I and all-cause mortality in patients with stable COPD: An analysis of the COSYCONET study.Eur Respir J.2019.https://erj.ersjournals.com/content/early/2019/11/13/13993003.01314-2019

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    2019-12-16 gous
  6. [GetPortalCommentsPageByObjectIdResponse(id=1900517, encodeId=e1d8190051e54, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Fri May 22 13:15:00 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005292, encodeId=48eb20052924d, content=<a href='/topic/show?id=8a9fe5298ad' target=_blank style='color:#2F92EE;'>#稳定性COPD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75298, encryptionId=8a9fe5298ad, topicName=稳定性COPD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Mar 03 00:15:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251523, encodeId=65ea12515232a, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388477, encodeId=a2f713884e72e, content=<a href='/topic/show?id=7ef25e5346b' target=_blank style='color:#2F92EE;'>#敏感性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57534, encryptionId=7ef25e5346b, topicName=敏感性)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJnkE6UvGFfMS41qV0RicWvVTTeLMicqibeZH5GqO4YhNicyl1Y9jFhylIUBn9ntPYy9jhk5hrfic5cRYw/132, createdBy=5f822500020, createdName=ms5236388012055669, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488850, encodeId=ec3e1488850fe, content=<a href='/topic/show?id=69675090ca' target=_blank style='color:#2F92EE;'>#COPD患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5090, encryptionId=69675090ca, topicName=COPD患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852e8475198, createdName=gous, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576059, encodeId=db6815e605912, content=<a href='/topic/show?id=10f7810863d' target=_blank style='color:#2F92EE;'>#肌钙蛋白I#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81086, encryptionId=10f7810863d, topicName=肌钙蛋白I)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d016291895, createdName=sunrural_42825362, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377009, encodeId=67b33e700995, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Mon Dec 16 05:55:53 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376960, encodeId=9ac33e696098, content=学习了很有用不錯, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sun Dec 15 00:09:47 CST 2019, time=2019-12-15, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1900517, encodeId=e1d8190051e54, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Fri May 22 13:15:00 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005292, encodeId=48eb20052924d, content=<a href='/topic/show?id=8a9fe5298ad' target=_blank style='color:#2F92EE;'>#稳定性COPD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75298, encryptionId=8a9fe5298ad, topicName=稳定性COPD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Mar 03 00:15:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251523, encodeId=65ea12515232a, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388477, encodeId=a2f713884e72e, content=<a href='/topic/show?id=7ef25e5346b' target=_blank style='color:#2F92EE;'>#敏感性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57534, encryptionId=7ef25e5346b, topicName=敏感性)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJnkE6UvGFfMS41qV0RicWvVTTeLMicqibeZH5GqO4YhNicyl1Y9jFhylIUBn9ntPYy9jhk5hrfic5cRYw/132, createdBy=5f822500020, createdName=ms5236388012055669, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488850, encodeId=ec3e1488850fe, content=<a href='/topic/show?id=69675090ca' target=_blank style='color:#2F92EE;'>#COPD患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5090, encryptionId=69675090ca, topicName=COPD患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852e8475198, createdName=gous, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576059, encodeId=db6815e605912, content=<a href='/topic/show?id=10f7810863d' target=_blank style='color:#2F92EE;'>#肌钙蛋白I#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81086, encryptionId=10f7810863d, topicName=肌钙蛋白I)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d016291895, createdName=sunrural_42825362, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377009, encodeId=67b33e700995, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Mon Dec 16 05:55:53 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376960, encodeId=9ac33e696098, content=学习了很有用不錯, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sun Dec 15 00:09:47 CST 2019, time=2019-12-15, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1900517, encodeId=e1d8190051e54, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Fri May 22 13:15:00 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005292, encodeId=48eb20052924d, content=<a href='/topic/show?id=8a9fe5298ad' target=_blank style='color:#2F92EE;'>#稳定性COPD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75298, encryptionId=8a9fe5298ad, topicName=稳定性COPD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Mar 03 00:15:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251523, encodeId=65ea12515232a, content=<a href='/topic/show?id=874529332ba' target=_blank style='color:#2F92EE;'>#全因死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29332, encryptionId=874529332ba, topicName=全因死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388477, encodeId=a2f713884e72e, content=<a href='/topic/show?id=7ef25e5346b' target=_blank style='color:#2F92EE;'>#敏感性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57534, encryptionId=7ef25e5346b, topicName=敏感性)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJnkE6UvGFfMS41qV0RicWvVTTeLMicqibeZH5GqO4YhNicyl1Y9jFhylIUBn9ntPYy9jhk5hrfic5cRYw/132, createdBy=5f822500020, createdName=ms5236388012055669, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488850, encodeId=ec3e1488850fe, content=<a href='/topic/show?id=69675090ca' target=_blank style='color:#2F92EE;'>#COPD患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5090, encryptionId=69675090ca, topicName=COPD患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852e8475198, createdName=gous, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576059, encodeId=db6815e605912, content=<a href='/topic/show?id=10f7810863d' target=_blank style='color:#2F92EE;'>#肌钙蛋白I#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81086, encryptionId=10f7810863d, topicName=肌钙蛋白I)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d016291895, createdName=sunrural_42825362, createdTime=Mon Dec 16 13:15:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377009, encodeId=67b33e700995, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Mon Dec 16 05:55:53 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376960, encodeId=9ac33e696098, content=学习了很有用不錯, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sun Dec 15 00:09:47 CST 2019, time=2019-12-15, status=1, ipAttribution=)]
    2019-12-15 飛歌

    学习了很有用不錯

    0

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