UNASSIGNED: This was a prospective cohort study of 390 patients (mean age 64 years; 65.6% male) with uNAG measurement on admission (expressed as urinary NAG/urinary creatinine) and at least 1 year of follow-up data. The pre-defined primary endpoint was the composite of all-cause mortality or rehospitalization for HF after discharge. Cox regression analysis, restricted cubic splines, and subgroup analysis were used to investigate the prognostic value of uNAG modeled as a categorical (quartiles) or continuous (per SD increase) variable.
UNASSIGNED: A total of 153 (39.23%) patients reached the composite endpoint over a median follow-up time of 1.2 years. The uNAG level correlated with the severity of HF and with the incidence of adverse events. In a multivariable Cox regression model, each SD (13.80 U/g ⋅ Cr) of increased uNAG was associated with a 17% higher risk of death or HF rehospitalization (95% confidence interval, 2-33%, p = 0.022), and a 19% higher risk of HF rehospitalization (p = 0.027). Subgroup analysis revealed the associations between uNAG and poor prognosis were only significant in younger patients ( ≤ 65 years) and in patients without obvious cardiovascular comorbidities.
UNASSIGNED: uNAG levels at admission were associated with the risk of adverse outcomes in patients with HF and MR. Additional studies are needed to further investigate the heart-kidney interaction.
■这是一项前瞻性队列研究,包括390名患者(平均年龄64岁;65.6%为男性),入院时进行uNAG测量(以尿NAG/尿肌酐表示)和至少1年的随访数据。预定义的主要终点是全因死亡率或出院后因HF再住院的复合终点。Cox回归分析,受限三次样条,和亚组分析用于研究以分类(四分位数)或连续(每SD增加)变量建模的uNAG的预后价值。
■共有153名(39.23%)患者在1.2年的中位随访时间内达到了复合终点。uNAG水平与HF的严重程度和不良事件的发生率相关。在多变量Cox回归模型中,uNAG增加的每个SD(13.80U/g·Cr)与死亡或HF再住院风险增加17%相关(95%置信区间,2-33%,p=0.022),心力衰竭再住院的风险增加19%(p=0.027)。亚组分析显示,uNAG与不良预后之间的关联仅在年轻患者(≤65岁)和无明显心血管合并症的患者中有统计学意义。
■uNAG水平与HF和MR患者的不良结局风险相关。需要更多的研究来进一步研究心-肾的相互作用。