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Int J Cardiol:疑似心肌梗死患者的生长分化因子-15和全因死亡率

2019-05-26 xing.T 网络

由此可见,急诊GDF-15浓度对疑似AMI患者的全因死亡的预测具有较高的准确性,可以确定大部分死亡风险极低的AMI患者。

近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员旨在评估生长分化因子-15(GDF-15)浓度在未选择的基于高敏感性心肌肌钙蛋白(hs-cTn)判定的疑似急性心肌梗死(AMI)患者中预后表现。

在一项正在进行的前瞻性多中心诊断研究中,纳入了因疑似急性心肌梗死在急诊连续就诊的患者以及GDF-15和hs-cTnT浓度可用的患者。两名独立的心脏病专家使用所有可用的临床信息(包括心脏成像和连续hs-cTn浓度)对AMI进行评估。

总体而言,该研究纳入了718名患者,其中23%(162/718)患者确诊为AMI。在AMI患者中,2年内累计死亡率为19%(162例患者中有30例死亡),而无AMI患者为5%(556例患者中有25例死亡; P<0.001)。在AMI患者中,GDF-15对于2年死亡的AUC为0.89(95%置信区间[CI]为0.83-0.94),而hs-cTnT的AUC为0.55(95%CI为0.44-0.66)(P<0.001)。 GDF-15截止值≤1560ng/L可预测AMI患者中47%(76/162)的个体2年生存率,2年死亡率敏感性为100%(95%CI为88-100%)。在没有AMI的患者中,GDF-15的AUC为0.83(95%CI为0.76-0.89),而hs-cTnT的AUC为0.76(95%CI为0.67-0.85)(P=0.096)。 GDF-15截止值≤886ng/L预测非AMI患者的2年生存率为37%(203/556),2年死亡率敏感性为100%(95%CI为86-100%)。 

由此可见,急诊GDF-15浓度对疑似AMI患者的全因死亡的预测具有较高的准确性,可以确定大部分死亡风险极低的AMI患者。 

原始出处:

JoanWalter,et al.Growth differentiation factor-15 and all-cause mortality in patients with suspected myocardial infarction.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.04.088

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