Gender Differences in Prognostic Markers of All-Cause Death in Patients with Acute Heart Failure: a Prospective 18-Month Follow-Up Study
Gender Differences in Prognostic Markers of All-Cause Death in Patients with Acute Heart Failure: a Prospective 18-Month Follow-Up Study
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急性心力衰竭患者全因死亡预后标志物的性别差异：一项前瞻性 18 个月随访研究
DOI：
10.1007/s12265-019-09893-2
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发表时间：
2019-05
影响因子：
3.4
通讯作者：
Xinli Li
中科院分区：
文献类型：
--
作者：
Xiaoting Wu;Mengli Chen;Kai Wang;Rongrong Gao;Xinli Li
急性心力衰竭(AHF)是一种严重威胁生命的疾病，预后差。性别差异在各种心血管疾病中得到了越来越多的认识。本研究旨在基于一项18个月的前瞻性随访研究，评估AHF患者全因死亡的性别特异性预后标志物。数据收集自419名AHF住院患者，他们以全因死亡为主要终点进行了18个月的随访。所有患者的平均年龄为60.9 ± 15.7岁，其中男性277例，女性142例。在该队列中，女性瓣膜病(37.3%)和房颤(45.8%)的发生率高于男性，而心肌病(30.3%)的发生率低于男性。多元逐步回归分析和ROC曲线分析表明，舒张压(DBP)、血钠、血肌酐和肺动脉收缩压(PASP)是男性AHF患者全死因死亡的独立预测因素，而女性患者的收缩压(SBP)、血清天冬氨酸转氨酶(AST)、血肌酐和D-二聚体是独立的预测因素。Kaplan-Meier分析显示，随着时间的推移，男性急性心力衰竭患者全因死亡的概率更高，其中舒张压 ≤ 为77 mm，血钠≤ 为138.5 mm，血肌酐≥ 为126.2μM，或≥ 为52 mm Hg，女性为SBP≤ 为129 mm Hg，血清AST>； 为29.3U/L，血清肌酐≥ 为102.7μM，或血清D-二聚体≥ 为1.76 mg/L。
Acute heart failure (AHF) is a life-threatening condition with poor prognosis. Gender differences have been increasingly recognized in diverse cardiovascular diseases. The present study aimed to evaluate gender-specific prognostic markers of all-cause death in AHF patients based on a prospective 18-month follow-up study. Data were collected from 419 patients with AHF hospitalization who were followed up for 18 months using all-cause death as primary endpoint. The mean age of all patients was 60.9 ± 15.7 years old, 277 were males, and 142 were females. Females had higher rate of valvular heart disease (37.3%) and atrial fibrillation (45.8%) but lower rate of cardiomyopathy (30.3%) than males in this cohort. Based on multiple COX stepwise regression and ROC curve analysis, diastolic blood pressure (DBP), serum sodium, serum creatinine, and pulmonary artery systolic pressure (PASP) were identified as independent predictors of all-cause death in male AHF patients, while systolic blood pressure (SBP), serum aspartate transaminase (AST), serum creatinine, and serum D-dimer as independent predictors in females. Kaplan-Meier analysis showed a higher probability of all-cause death over time in male AHF patients with DBP ≤ 77 mmHg, serum sodium ≤ 138.5 mM, serum creatinine ≥ 126.2 μM, or PASP ≥ 52 mmHg, and in female AHF patients with SBP ≤ 129 mmHg, serum AST > 29.3 U/L, serum creatinine ≥ 102.7 μM, or serum D-dimer ≥ 1.76 mg/L. In conclusion, these data provide novel insights into gender differences in prognostic markers of outcomes of AHF patients.
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影响因子：
1.5
作者：
Meng FC;Li YH;Lin GM;Lin CS;Yang SP;Lin WH
通讯作者：
Lin WH
DOI：
10.1161/circheartfailure.116.003613
发表时间：
2017-04
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Upadhya B;Rocco M;Lewis CE;Oparil S;Lovato LC;Cushman WC;Bates JT;Bello NA;Aurigemma G;Fine LJ;Johnson KC;Rodriguez CJ;Raj DS;Rastogi A;Tamariz L;Wiggers A;Kitzman DW;SPRINT Research Group
通讯作者：
SPRINT Research Group
影响因子：
4.8
作者：
Sherwood A;Hill LK;Blumenthal JA;Adams KF Jr;Paine NJ;Koch GG;O'Connor CM;Johnson KS;Hinderliter AL
通讯作者：
Hinderliter AL
影响因子：
7.9
作者：
Bell JR;Curl CL;Harding TW;Vila Petroff M;Harrap SB;Delbridge LMD
通讯作者：
Delbridge LMD
影响因子：
18.2
作者：
Szwejkowski, Benjamin R.;Elder, Douglas H. J.;Lang, Chim C.
通讯作者：
Lang, Chim C.