Usefulness of the blood hematocrit level to predict development of heart failure in a community.
Usefulness of the blood hematocrit level to predict development of heart failure in a community.
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DOI：
10.1016/j.amjcard.2011.08.037
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发表时间：
2012-01-15
影响因子：
2.8
通讯作者：
Moore, Lynn L.
中科院分区：
文献类型：
--
作者：
Coglianese, Erin E.;Qureshi, Muhammad M.;Vasan, Ramachandran S.;Wang, Thomas J.;Moore, Lynn L.
目前的数据表明，血红蛋白的增加可能会减少一氧化氮，并对血管功能产生不利影响。在临床前环境中，这些变化可能加速心力衰竭（HF）的发展。我们假设，较高的红细胞压积（HCT）与社区新发HF的发病率增加有关。我们评估了3，523名参与者（59%为女性），他们来自心脏病研究，年龄在50至65岁之间，没有HF。对参与者进行前瞻性随访，直至发生HF事件、死亡或20年随访结束。HCT分为4个性别特异性类别（女性：HCT 36.0至40.0，40.1至42.0，42.1至45.0，> 45.0;男性：39.0至44.0，44.1至45.0，45.1至49.0，> 49.0）。采用性别合并的多变量考克斯比例风险模型来估计HCT与HF事件的相关性，并对临床风险因素进行调整。在随访期间（61，417人年），217名参与者发生HF（女性100起事件）。在4个HCT类别中，HF风险呈线性增加（趋势p = 0.002）。与最低HCT类别相比，正常低、正常和高HCT类别中HF的风险比分别为1.27（95%置信区间0.82至1.97）、1.47（1.01至2.15）和1.78（1.15至2.75）（趋势p <0.0001）。对其他心血管疾病的中期发展进行调整，并将样本限制在不吸烟者中，这并没有改变结果。总之，在这项长期随访研究中，高水平的HCT，即使在正常范围内，也与发生HF的风险增加相关。
Current data suggest that increases in hemoglobin may decrease nitric oxide and adversely affect vascular function. In the preclinical setting, these changes could precipitate the development of heart failure (HF). We hypothesized that higher hematocrit (HCT) would be associated with an increased incidence of new-onset HF in the community. We evaluated 3,523 participants (59% women) from the Framingham Heart Study who were 50 to 65 years old and free of HF. Participants were followed prospectively until an HF event, death, or the end of 20 years of follow up. HCT was subdivided into 4 gender-specific categories (women: HCT 36.0 to 40.0, 40.1 to 42.0, 42.1 to 45.0, >45.0; men: 39.0 to 44.0, 44.1 to 45.0, 45.1 to 49.0, >49.0). Gender-pooled multivariable Cox proportional hazards models were used to estimate the association of HCT with incident HF, adjusting for clinical risk factors. During the follow-up period (61,417 person-years), 217 participants developed HF (100 events in women). There was a linear increase in risk of HF across the 4 HCT categories (p for trend = 0.002). Hazards ratios for HF in the low–normal, normal, and high HCT categories were 1.27 (95% confidence interval 0.82 to 1.97), 1.47 (1.01 to 2.15), and 1.78 (1.15 to 2.75), respectively, compared to the lowest HCT category (p for trend <0.0001). Adjustment for interim development of other cardiovascular diseases and restriction of the sample to nonsmokers did not alter the results. In conclusion, higher levels of HCT, even within the normal range, were associated with an increased risk of developing HF in this long-term follow-up study.
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影响因子：
39.3
作者：
Natali, A;Toschi, E;Ferrannini, E
通讯作者：
Ferrannini, E
DOI：
10.1016/0735-1097(95)00007-q
发表时间：
1995-05-01
影响因子：
24
作者：
ANAND, IS;CHANDRASHEKHAR, Y;CHAWLA, LS
通讯作者：
CHAWLA, LS
影响因子：
4.8
作者：
GAGNON, DR;ZHANG, TJ;KANNEL, WB
通讯作者：
KANNEL, WB
影响因子：
4.8
作者：
SORLIE, PD;GARCIAPALMIERI, MR;HAVLIK, RJ
通讯作者：
HAVLIK, RJ
影响因子：
--
作者：
KANNEL, WB;SORLIE, P
通讯作者：
SORLIE, P