Higher sRAGE Levels Predict Mortality in Frail Older Adults with Cardiovascular Disease
Higher sRAGE Levels Predict Mortality in Frail Older Adults with Cardiovascular Disease
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DOI：
10.1159/000512287
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发表时间：
2021-01-21
期刊：
影响因子：
3.5
通讯作者：
Erusalimsky, Jorge D.
中科院分区：
文献类型：
--
作者：
Butcher, Lee;Carnicero, Jose Antonio;Erusalimsky, Jorge D.
简介：晚期糖基化终末产物可溶性受体（sCRP）血液水平预测心血管疾病（CVD）患者死亡率的证据不一致。为了澄清这一问题，我们调查了虚弱状态是否会影响这种关联。方法：我们分析了来自3个基于人群的欧洲队列的1，016名个体（中位年龄为75岁）的数据，这些个体参加了FRACTUMIC项目。参与者按CVD病史和虚弱状态分层。在8年的随访期间记录死亡率。结果如下：在校正的考克斯回归模型中，基线血清肌酐水平与CVD受试者的死亡风险增加呈正相关（HR 1.64，95% CI 1.09-2.49，p = 0.019），但与非CVD受试者无关。在CVD组中，与非虚弱亚组（CVD-NF，HR 1.50，95% CI 0.71-3.15，p = 0.287）相比，虚弱亚组（CVD-F，HR 1.97，95% CI 1.18 -3.29，p = 0.009）的死亡风险显著增加。Kaplan-Meier分析显示，高sCRP（> 1，554 pg/mL）的CVD-F的中位生存时间比低sCRP的CVD-F短2.9年，而CVD-NF的生存期无差异。ROC曲线下面积分析表明，对于CVD-F，将sCRP加入预测模型可增加其预后价值。结论：虚弱状态影响老年CVD患者的生存率和死亡率之间的关系。对于这些个体，特别是如果他们也是虚弱的，sleep可以用作死亡率的预后标志。
Introduction: The evidence that blood levels of the soluble receptor for advanced glycation end products (sRAGE) predict mortality in people with cardiovascular diseases (CVD) is inconsistent. To clarify this matter, we investigated if frailty status influences this association. Methods: We analysed data of 1,016 individuals (median age, 75 years) from 3 population-based European cohorts, enrolled in the FRAILOMIC project. Participants were stratified by history of CVD and frailty status. Mortality was recorded during 8 years of follow-up. Results: In adjusted Cox regression models, baseline serum sRAGE was positively associated with an increased risk of mortality in participants with CVD (HR 1.64, 95% CI 1.09-2.49, p = 0.019) but not in non-CVD. Within the CVD group, the risk of death was markedly enhanced in the frail subgroup (CVD-F, HR 1.97, 95% CI 1.18-3.29, p = 0.009), compared to the non-frail subgroup (CVD-NF, HR 1.50, 95% CI 0.71-3.15, p = 0.287). Kaplan-Meier analysis showed that the median survival time of CVD-F with high sRAGE (>1,554 pg/mL) was 2.9 years shorter than that of CVD-F with low sRAGE, whereas no survival difference was seen for CVD-NF. Area under the ROC curve analysis demonstrated that for CVD-F, addition of sRAGE to the prediction model increased its prognostic value. Conclusions: Frailty status influences the relationship between sRAGE and mortality in older adults with CVD. sRAGE could be used as a prognostic marker of mortality for these individuals, particularly if they are also frail.