This prospective cohort study included 411 consecutive hospitalized patients with AHF. During hospitalization, fasting plasma samples were collected within the first 24 h of admission. Plasma 2OG levels were measured by hydrophilic interaction liquid chromatography-liquid chromatography tandem mass spectrometry (HILIC-LC/MS/MS). All participants were followed up for six months. Multiple logistic regression was used to determine the odds ratio (OR) and 95% confidence interval (CI) for primary outcomes.
The AHF cohort consisted of HF with preserved ejection fraction (EF) (64.7%), mid-range EF (16.1%), and reduced EF (19.2%), the mean age was 65 (±13) years, and 65.2% were male. Participants were divided into two groups based on median 2OG levels (μg/ml): low group (< 6.0, n = 205) and high group (≥6.0, n = 206). There was a relatively modest correlation between 2OG and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels (r = 0.25; p < 0.001). After adjusting for age, sex, and body mass index, we found that the progression of the NYHA classification was associated with a gradual increase in plasma 2OG levels (p for trend< 0.001). After six months of follow-up, 76 (18.5%) events were identified. A high baseline 2OG level was positively associated with a short-term rehospitalization and all-cause mortality (OR: 2.2, 95% CI 1.3-3.7, p = 0.003), even after adjusting for NT-proBNP and estimated glomerular filtration rate (eGFR) (OR: 1.9, 95% CI 1.1-3.4, p = 0.032). After a similar multivariable adjustment, the OR was 1.4 (95% CI 1.1-1.7, p = 0.018) for a per-SD increase in 2OG level.
High baseline 2OG levels are associated with adverse short-term outcomes in patients with AHF independent of NT-proBNP and eGFR. Hence plasma 2OG measurements may be helpful for risk stratification and treatment monitoring in AHF.
ChiCTR-ROC-17011240 . Registered 25 April 2017.
这项前瞻性队列研究包括411名连续的AHF住院患者。住院期间,在入院的前24小时内收集空腹血浆样本.通过亲水作用液相色谱-液相色谱串联质谱(HILIC-LC/MS/MS)测量血浆20G水平。所有参与者均随访6个月。使用多元逻辑回归确定主要结局的比值比(OR)和95%置信区间(CI)。
AHF队列包括射血分数(EF)保留的HF(64.7%),中档EF(16.1%),并降低EF(19.2%),平均年龄为65(±13)岁,65.2%为男性。根据中位数2OG水平(μg/ml)将参与者分为两组:低组(<6.0,n=205)和高组(≥6.0,n=206)。在2OG和N末端B型利钠肽前体(NT-proBNP)水平之间存在相对适度的相关性(r=0.25;p<0.001)。在调整了年龄之后,性别,和身体质量指数,我们发现,NYHA分级的进展与血浆2OG水平的逐渐升高相关(趋势p<0.001).经过六个月的随访,发现76例(18.5%)事件。高基线2OG水平与短期再住院和全因死亡率呈正相关(OR:2.2,95%CI1.3-3.7,p=0.003),即使在校正NT-proBNP和估计肾小球滤过率(eGFR)后(OR:1.9,95%CI1.1-3.4,p=0.032)。经过类似的多变量调整后,2OG水平每SD增加的OR为1.4(95%CI1.1-1.7,p=0.018)。
独立于NT-proBNP和eGFR的AHF患者高基线2OG水平与不良短期预后相关。因此,血浆2OG测量可能有助于AHF的风险分层和治疗监测。
ChiCTR-ROC-17011240。2017年4月25日注册