Abstract:
Congestive heart failure (CHF) is associated with significant morbidity and mortality. There has been renewed interest in using thrombo-inflammatory markers as prognostic tools in patients with CHF. To determine if thrombo-inflammatory markers are independent risk factors for 28-day mortality in hospitalized CHF patients, we retrospectively analyzed admission data extracted from 2008 consecutive patients admitted with a diagnosis of CHF to Zigong Fourth People\'s Hospital. Multivariate Cox proportional hazards analysis demonstrated that the thrombo-inflammatory markers thrombin time, platelet/lymphocyte ratio (PLR), and D-dimer level were independent predictors of mortality. In addition, variables reflecting the severity of CHF (New York Heart Association class > 2), impaired renal function (elevated serum creatinine [SCr]), impaired organ perfusion (elevated BUN), and chronic liver disease were also independent predictors of mortality. Thrombo-inflammatory biomarkers were only weakly associated with SCr and the burden of co-morbidity, suggesting that thrombo-inflammation may in large part be attributable to CHF itself and that, moreover, its presence may confer an increased risk of mortality. Further large-scale prospective studies are needed to determine the existence and the consequences of a thrombo-inflammatory phenotype among patients with CHF.
摘要:
充血性心力衰竭(CHF)与显著的发病率和死亡率相关。人们对使用血栓炎症标志物作为CHF患者的预后工具重新产生了兴趣。为了确定血栓炎症标志物是否是住院CHF患者28天死亡率的独立危险因素,我们回顾性分析了2008年自贡市第四人民医院诊断为CHF的连续患者的入院资料.多因素Cox比例风险分析表明,血栓-炎症标志物凝血酶时间,血小板/淋巴细胞比率(PLR),D-二聚体水平是死亡率的独立预测因子。此外,反映CHF严重程度的变量(纽约心脏协会类别>2),肾功能受损(血清肌酐[SCr]升高),器官灌注受损(BUN升高),慢性肝病也是死亡率的独立预测因子.血栓-炎症生物标志物仅与SCr和共病负担弱相关,这表明血栓炎症在很大程度上可能归因于CHF本身,此外,它的存在可能会增加死亡风险。需要进一步的大规模前瞻性研究来确定CHF患者血栓炎症表型的存在和后果。